My father had an extra cycle added to his PD last week. Since then, he has started coughing on occasion. Last night, it got pretty bad. Has anyone else noticed changes in PD after adding a cycle?
Why did his prescription change? Is he drinking a lot of fluid? A cough could indicate fluid in or around his lungs. Does he cough when he’s off dialysis or just when he’s on dialysis? Have any of his medications changed at the same time. Some BP meds cause coughs. Have you reported this to his home training nurse and his nephrologist?
The common cause of cough in PD is higher volume fills putting pressure on the diaphragm. Even if the cycled is just added but not changed, he can have carry over from his previous cycles if he has a tidal setting. I do not think it’s fluid on the lungs at all.
What was the rationale for adding a cycle? What’s his bun what’s his Cr? How much diuretics is he taking? 2.5% or 1.5% and how long on PD?
Thanks
Thank you both for your replies. The sixth cycle was added because he has a permeable peritoneum so they added a cycle and lowered the dwell time. He gets 15,000 ml of 1.5%, with an occasional 2.5% when his UF is below 0. He’s been on PD for 6 months after being on hemo for 4 months.
His nurse thinks it’s post nasal drip (allergy season) because his chest is clear. He’s had no medication changes either. He’s had some hallucinations lately too. We think it’s a reaction to cough medicine or untreated sleep apnea. We’re tracking both of those. Never a dull moment!
Is he on high dose diuretics? How much fluid are they telling him to drink?
No diuretics. He gets about 3-4 cups of water a day, but he doesn’t drink it all, Stubborn.
Our patients are asked to drink 2L a day and they take diuretics high volume to keep their kidneys working. When you restrict fluids and use 2.5% just reduce kidney function via dehydration. If he urinates more you can reduce the additional exchange. Urine is the liquid gold of kt/v and I tell the patients to think of urine as 500cc being equal to an entire 2L exchange. The nurses in the PD program must work to be innovative and learn more about dialysis, because typically in PD programs it’s nurse led, physician supports. Use his residual function and less dialysis is our philosophy.
My Dad has low renal function, which could affect the water amount he’s given to drink. I’ll ask his nephrologist about your method. Thanks for all your input.
We have GFR of 6 that are on high diuretics with 2500cc output. It just whether or not the nephrologist is up to date with current research. Hopefully as we attend more conference we can get everyone off of restrictive fluid intake and every home dialysis patients on a diuretic. Hopefully you can cut down on the cycles soon!
Is there published research on this approach? I’d be very interested in reading it if you provide a link. Thanks!
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