Initial Drain on Cycler

I’ve been on the cycler during the night for approximately two weeks. My initial drain in the evening doesn’t get near the amount of fluid out as was put in me that morning on my last fill. My overall UF is good. I’m trying to see if anyone else has experienced this and what the nephrologist has done so I can be prepared when I see my doctor. I’m afraid he’ll say to drain during the day…which I don’t want to do; I’m prepared to ask him to leave me empty during the day…but I’m sure he’ll resist. Would like some ammunition.

We’ve been going through the same thing with my mom. The problem she was having was too many ID alarms which was due to absorbing too much of the last cycler fill during the day which was also causing more edema in her legs. What we first did was drain around noon and then either go dry until night where we bypassed the ID, or we would fill her after dinner so the machine would get the 70% (or whatever the nurse set it too) to eliminate the alarms. You can talk to your nurse and see if they will work with you to help avoid the ID alarms. Do not bypass the ID alarm without making sure you are empty or you could possibly overfill, which is not good. If your UF is good and you aren’t experiencing extra edema, you could ask that you try to go dry during the day. There is no exact Rx that fits everyone and they should be willing to try different things to make you more comfortable. Good luck

Our PD nurse actually has the ID in the evening set so no alarms go off regardless of my husband’s ID amount…which helps. We see the doctor next week and I’m sure he’ll decide how to treat the fact that his body absorbs too much during the day. He has no edema any longer though. Hope your mom is doing better. Personally, the mid-day drain isn’t an option for us, unless it’s a last resort. Too many doctors are against going dry during the day even if the patient is doing well. I feel it’s at least worth a try.

I’m not sure if that’s a good idea either? If the alarm doesn’t go off when he gets to a “low volume drain” (where possibly he only needs to roll over) and then switches over to fill, he could overfill. If his numbers are good and he’s getting adequate dialysis, how about asking the doctor if you can lower his last fill to something minimum that would eliminate him going dry during the day, but will also leave a couple hundred mL in him that he’s probably going to absorb anyway? This way, when he goes on the cycler at night, there’s no chance of an overfill, no alarms etc. Right now my mom is doing a mid day exchange and then after dinner she drains so that she goes on the machine empty and bypasses the intial drain. I’ve also lowered her machine 12 inches below her bed which seems to be helping with the drains. Good luck and you’re doing the right thing by trying to learn as much as you can. Your doctors and PD nurses should be willing to work with you to make your husband’s therapy “fit your lifestyle”.

My son has this too, he leaves in 1000 and sometimes his initial drain would be 500. I spoke to the dialysis nurses and they said that he is absorbing some of the fluid during the day and that it is completely normal. there are some nights when it will be close to 900 but i have to bypass the alarm almost every night. they never said anything about a manual drain. As long as the uf was good that was important.

Hi - have just found this message board; these comments may be of use.
Having a crisis with ESRF May 2006 have been on peritneal dialysis since July 2006. Initially did CAPD and found same problem; first exchange in the morning showed absorbtion of 500 to 900ml of fluid overnight. After this went on for weeks changed to an Extraneal fluid for the long overnight dwell, instead of the Physioneal fluid I used during other exchanges, and this largely solved problem. Have converted to CCPD and cycler uses Extraneal for the long dwell (now during the day) and still no problems.
Can’t quite beleive that your nurse / doctor havent considered this simple solution.
Good luck - Nicko

I am new to a cycler. How does everyone secure their catheter on your body and still sleep comfortable.

Here are some PD products in the Helpful Products Catalog (linked on the Home Dialysis Central homepage), including different types of products to secure PD catheters.