HI,
I am glad I found this site. My mom has just started PD due to kidney failure from her Scleroderma. She has had alot of fluid build up from the kidney failure and her last hospital stay she had fluid overload. She has been on oxygen since she came home. She gets short of breath. My question is to find out from others if starting the PD and over time will help with the fluid around the lungs? She has never had to be on oxygen before, but we hope that over time the fluid build up will get better and she will feel better and not be so winded. Hoping I can hear from others to give us some help & hope. Thanks!
Your email brings up many questions a few of which include:
– When your mother was hospitalized with fluid overload, did they ever do hemodialysis?
– When did she start on PD and has she completed training?
– Is she doing CAPD (manual exchanges) or CCPD (cycler)?
– If she’s on CAPD, does she use 2 liter bags of solution (more/less) and how many CAPD exchanges does she do each day?
– What dialysis solution is she using – 1.5%, 2.5%, or 4.25%?
– Does she drain off more fluid than she puts in?
– How closely is she sticking with her fluid restriction?
– How well is she limiting salt?
– Does she weigh everyday and is her weight going up/down/stable?
– How is her blood pressure…is it going up/down/stable?
New CAPD patients often complain that they feel full until their body gets used to carrying 2 liters of fluid around in their peritoneal cavity. The fluid presses on the lungs and some women say that carrying the fluid feels like being pregnant. Those on CCPD who use a cycler while they sleep may leave some fluid in their peritoneal cavity during the day or they may not, depending on their dialysis prescription. Typically the amount they leave inside is not really noticeable.
Feeling winded could due to other reasons besides the PD fluid.
– She could be anemic. Most people with kidney failure are. If her hemoglobin is <11 gm/mL (or her hematocrit <33%), she may need EPO to build her red blood cells that will carry more oxygen to her tissues.
– She could be debilitated if she has been sick for a while and hasn’t done much walking or other physical activity. She may need to build up her strength and endurance slowly.
– She could have breathing problems related to her scleroderma.
If the shortness of breath is getting worse not better, I’d call and talk with her home training nurse or nephrologist to report such things as her weight, blood pressure, and how difficult it is for her to breathe on a zero (no problem at all) to ten (can’t catch her breath) scale. Make sure that they understand that this is not her usual level of functioning.
Hi Sharon, welcome to Home Dialysis Central. Your mom is very lucky to have you helping her to find information. In addition to what Beth wondered about, has your mom had any lung involvement of her scleroderma? A quick Google search found that it can cause pulmonary fibrosis (scarring of the lungs that makes it harder to inflate them all the way, causing shortness of breath). So, it will be important to sort out whether her shortness of breath might be due to:
– Not enough fluid removal with PD
– Her scleroderma
– Both
It looks as if the International Scleroderma Network has a very informative website that may be able to help you on the scleroderma and lung side (http://www.sclero.org/medical/symptoms/pulmonary/a-to-z.html) and we’ll do our best on the dialysis side.
Hi,
Thanks for your replys. Here is the info that I can give you to get an idea of what is going on with my mom.
Never did hemo before, had fluid overload due to the irrigation that they were doing on her for blood in the urine.
She started CCPD last Monday ( a week ago) at her training class. She is on 4.25 and 2.5 for now. They said the 4.25 will help draw extra fluid out fill volume 1500- 5 cylers. Will probably not stay on the 4.25 for too long.She definately drains off more every time. Last night her total UF was 1678, and her weight does continue to go down.Was 52.1 and then 51.4 this morning.She does limit salt & fluid. Is good about all that.
Blood pressure staying around 140’s over 70’s.
Blood : H&H 10.5 (32.2) Gets shot every week of EPO
Phos 4.2 and creat. last week was 7.1, but I am sure those have changed a bit since it has been a few days, and has been doing the CCPD every night.
She is staying with us for now till she gets her strength up, and gets discouraged about being short of breath and having to use the oxygen. Has not been very active as she was, so I am sure that also has something to do with it. Has been doing alittle more each day.
She has had little lung involvement from the Scleroderma.
So, my question was in the hopes that the fluid coming off will help over time with her breathing, and she will not be so short of breath and can get off the oxygen
Thanks Again!