Low Blood Pressure

Hi Guys,

Back again after a quiet / uneventful time in my wifes journey with Dialysis.

She is now [ and has been for a good number of weeks ] on Home Dialysis with a Baxter Machine - no real problems in comparison to Hospital Dialysis. She has a tube between her stomach and peritonium. She is on bags of fluid each night - a combination of colour labelled boxes - Yellow, Green, Pink. Normally two yellow, one green OR three yellow - either of these combos with a smaller pink labelled bag also. The yellow and green labelled fluid is DIANEAL [ 5000 mls ], the pink is Extraneal [ 2000 mls ] - all by Baxter.

Her meds are currently - Tritace, One Alpha Capsules, Dilzem XL, Mimpara, Betaloc tabs, Folic Acid tabs. She also has Renagel and Orovite. She was recently started on Either the Mimpara OR the Betaloc, I think the Mimpara - this was something to do with a level of something related to thyroids, I would have to ask again about this.

She confessed to me today that both this morning [ Wednesday morning & just about an hour ago, Thursday 12.30am gmt before bed ] that she felt faint, she fell back on the couch when getting up. We took her BP and it was very low as i suspected.

I have read a few threads here about people on HD and who are having low BP. Just wanted to share this and interested in any further thoughts you guys may have after my description above,

Cheers & thanks AGAIN,

Hi Aidan,

Your wife should hopefully have been recording her blood pressure, temperature, and weight regularly. She should call her home training nurse or nephrologist and tell him/her what these have been over the past few days since before she felt faint. She should describe her symptoms, when they are better or worse, what medicine(s) she’d taken or dialysate she’d used before the symptoms got bad and what, if anything, has helped to relieve the symptoms. She should describe what any prescribed and over-the-counter drugs and herbs she’s taking. In addition, she should describe her eating, drinking and bowel habits since the symptoms started.

I haven’t seen boxes of dialysate with color coding so I don’t know what those colors mean, but can guess that it relates to the chemical concentration (dextrose, calcium, etc.) of the dialysate. It’s possible that if she’s been eating better since she got out of the hospital, she may be gaining “good weight.” Or she may have had diarrhea causing her to lose more fluid than expected. Her “dry weight” may need to be adjusted and she may need to adjust what solutions she uses to avoid getting dehydrated. One symptoms of dehydration with PD is feeling faint and having low blood pressure. However, since there are other things that can cause these symptoms, talking with the nurse or nephrologist as soon as possible is the best way to resolve this problem.

Hey Aidan
I’m not familiar with the color coding system you’re talking about, but with the Baxter system my partner uses the colored labels indicate different concentrations of dextrose (yellow being the lowest, red the highest and green is in the middle). The higher the concentration of dextrose, the more fluid he pulls off during a treatment. His PD nurse advised him to monitor his blood pressure, as well as any fluid retention, and based on these factors choose the combination of bags he places on the machine. She recommended the same thing when he was doing manual exchanges. Perhaps whatever combination your wife is using is pulling off too much fluid and lowering her blood pressure. I would suggest talking to her PD nurse and/or nephrologist for some suggestions.
Best of luck!

We are new to PD but my husband’s bags are color coded as Aidan has said. This morning his BP was so low we were told to use a green on the cycler and a yellow on the side to dilute. Also to he was to leave off his meds (which he had done the night before) drink plenty of fluids, eat some chicken noodle soup or something with salt. This afternoon before we started his exchange his BP was up and in a good range.

Apparently he has pulled off too much fluid.