My mother has chronic renal failure. She had CAPD as HD is not suiting her. From today they will start dialysis. Does it hurt? She is afraid about it. Most important thing is that she can’t eat, whatever she eats she vomits. Doctor says this will improve when dialysis will start. She also had lot of excess fluid in her belly. At the time of CAPD doctor took out a lot. But there are more. I have a question about dialysis chemical. How much she needs to use (in liter) at single dialysis? I will post details about her within few hours. I like to hear your opinion. Thanks.
Well, some people do get a little pain, but it is totally bearable. I get what we call “the drain pain”. It’s just a little pain at the end of the draining cycle. It’s from the catheter sucking on the walls of the peritoneum since there is no more fluid in there. Not many patients get it though. Most can’t feel anything when filling and draining. I’m a “lucky” one! lol
The nausea should get better after starting PD. It may take some time though bc she has to get all the built up toxins out of her body first. This takes time.
Everybody uses a diff amt of fluid per exchange according to their height, weight, kidney function, etc. No one here can give you a definite answer on how much she will receive at a time.
I just returned from the hospital. She had her first dialysis. It went well. Doctor will use 3 bags for next 7 days to lower her creatin and urea.
She is 5ft and weight 39 KG. I believe she will be ok soon.
If she’s going to be doing CAPD, she will need to learn how to do the dialysis exchange using sterile technique; how to choose the type of solution to take off the right amount of fluid weight she needs to remove; how to monitor her blood pressure, weight, temperature, etc.; how to understand her lab tests; and she’ll learn how to record her treatments so her doctor and dialysis clinic know how well she’s doing. If you have time to go through the training with her (and she’s willing to have you there), you would probably learn a lot.
I’m pretty confused about sterile gauges, can you tell how could I do that At home cause Its not possible for me to buy the sterile one cause they might not be sterile properly yet again during PD sterile boxes will be opened several times.
I’m pretty confused about sterile gauges, can you tell how could I do that At home cause Its not possible for me to buy the sterile one cause they might not be sterile properly yet again during PD sterile boxes will be opened several times.[/QUOTE]
It’s not a sterile gauge or anything that you need to buy, it’s sterile PD exchanges that your mom will need to do. An exchange is when she empties out the used fluid that was in her belly and fills up with fresh fluid. Each time you connect her PD catheter (belly tube) to a bag of fluid, you will need to wear a mask, wash your hands, and do the steps as the nurse teaches you. Most people who do PD can do these things themselves, so it may be your mom who learns to do these steps. Either way, the dialysis center will teach the steps and should make sure that you know them before your mom goes home for PD.
I know that but they told us before doing that exchange me or my mom have to clean up everything with germ killer we called it here hexasol and then do the dialysis but for that we need according to the nurse sterile gauge.
I think i’ve made you understand
Cleaning up with a product like hexasol makes sense, but I’m afraid I still don’t know what a “sterile gauge” would be.
Could the nurse mean that your mother needs to clean her exit site where the catheter comes out of her abdomen using a piece of sterile gauze (a loose weave surgical dressing) or did she say you needed to use sterile gauze soaked with Hexasol to wipe down the table before she places the items that she will use for the exchange? Once sterile gauze touches the table, it’s no longer sterile so don’t know that’s what she meant. I would suggest asking the nurse to show you what she means.
She is swelling from yesterday. Before CAPD she had lot of water in her belly. She was ok. But from yesterday her right leg is swelling and also now her belly. Nurses told us to take extra fluid out of her body 200ml extra in each dialysis (she is having 3 times each day). Now, when she sits, she felt pressure in her belly. Please, advice.
In the U.S. CAPD patients do at least 4 treatments a day. Some who are bigger do 5. If she’s removing more dialysate (dialysis fluid) than she’s putting in, she can reduce the amount of fluid that she’s taking into her body or to use a dialysis solution with a higher sugar content.
In the U.S. the solutions used are 1.5% dextrose, 2.5% dextrose, and 4.25% dextrose. The higher the sugar content, the more fluid will be pulled off. However, the higher the sugar content, the more likely the solution is to scar the peritoneal membrane. Therefore limiting fluid is usually what the dialysis staff recommend first. In the U.S. most patients are limited to about 1 liter fluid a day plus the amount of urine they make.
Ask the doctor if the catheter is in the right place inside her peritoneal cavity. The tip should be near her rectum. Some patients feel the catheter for a while until they get used to it. If the catheter has flipped up, it won’t do the best job of removing fluid. They should be able to x-ray to see the catheter. Sometimes the catheter will reposition itself with the patient’s movements or the doctor can reposition the catheter.
today after I changing my mom’s fluid I noticed some kind of floating fibre in the drained fluid and after few minuties fluid doesn’t seem to be clear as were in the morning after draining.
I don’t know what’s the reason. My mom’s doctor told me when we made this CAPD in her body that their might be some calcium loss through fluid but I’m pritty much afraid now.
What should be done now?
If what you’re seeing looks like strands of cotton, it could be fibrin which is harmless but can clog the catheter. In the U.S. nurses train patients how to inject a little heparin into one bag a day to dissolve the fibrin. Ask the training nurse if what you’re seeing could be fibrin and how to keep it from clogging the catheter.
If you can’t read the lettering on the front of the bag when looking through the solution through the back, she may have peritonitis. Call the nurse. Generally they want to take a sample from the bag to test it to see what bacteria is causing the peritonitis to know what antibiotic is best to treat the infection. Peritonitis should be treated right away. Not only can it be painful but the infection can scar the peritoneum making it less able to allow the wastes to pass through from the blood.
Here is a website from the UK that lists possible problems with peritoneal dialysis:
Ya you are right it’s looks like cotton fabric. I can inject heparin so it won’t be problem. There’s another thing, since from the begining of her dialysis an antibiotic injection is going on 3 times a day which is CEFTAZIDIME 500mg/vial. So i think there is no way infection could happen.
But still I need your suggestion and I’m looking the url you provided.
I would not suggest doing anything until you talk with her doctor or training nurse.
Why is she taking an antibiotic and how long has she been taking it?
Mom’s doctor is not avilable now but i talked with the nurse she suggested we better check to night drained fluid and let her know. I don’t know why this antibiotic is going on but doctor told us to continue for 14 days from the dialysis started, he also told to inject vancomycin on the 5th day and we also did that.
If she just recently had her catheter placed, it may be that the doctor prescribed antibiotic to try to prevent her from getting an infection.
What kind of training did you/she get in how to do PD at home? How many days and hours per day was it? Did her dialysis program provide any reading materials to take home to review later? What did the nurse tell her about how to care for her catheter? Was she taught how to use sterile technique to make connections?
Lots of question I try to answer. First of all my mom is a paralised patient and her right side is totally off. So she can’t do any part of the dialysis by herself. My father and me do the dialysis most of the time.It’s now 20 days after the operation and from today we are stopping to give the antibiotic.
Actually PD nurse showed us for 7 days for 3 times a day how to do the dialysis and keep everything in sterile condition while the nurse was doing the dialysis. So far no reading materials was provided for us to read that later.They only gave us a proforma to keep the record of her dialysis(i.e time, amount of fluid, any medication, fluid color etc). That is all.
Me after taking back my mom home experiencing lots of problem so far I’ve asked you some.
Thanks to you about my previous problem I’ve asked the doctor directly he told me give Heparin now her drained water is clear and we are putting her two litre 1.5% bags at moring and at night. Yet she feels pain in her back in the kidney position and also her lower abdomen. We told the nurse about this, she told us to make my mom to walk but she is so much weak that even we can’t move her while holding side by side. Doctor to keep her feed all the time. But she has a tendency not to eat we don’t know why?Before dialysis she used to vomit but now she doesn’t and takes food in small quantity. We try to give her rich food (like egg, milk, fruits etc) so that there should be no defiency. We are trying our best.
You might want to look at the nutrition module of Kidney School that fits with her condition. It’s divided into 4 sections: Hemodialysis with diabetes or not and PD with diabetes or not.
She needs to eat enough high biologic value protein (usually animal sources) to get her albumin level to at least 3.5. If her albumin level is low, she is at higher risk of infection, hospitalization, and even death. Eating several small meals a day is one way to help people with poor appetite get enough nutrition. Some fruits and vegetables can be high in potassium which can affect muscles and make them weak and can cause the heart to beat irregularly. Be sure you know which fruits and vegetables have high levels of potassium.
If she’s depressed (which is common especially with people who are new to kidney failure and dialysis), this could affect her appetite. You might want to read the module of Kidney School on coping with kidney disease.
If she’s weak, it could be because she’s anemic. Most patients on dialysis are. She may need iron and EPO shots to help build up the red blood cells that carry oxygen to the body tiessues. Without oxygen muscles get weak.
It could also be because she’s debilitated and needs to move around a little more. Helping her to walk short distances several times a day can help her to build up strength. Life Options has an exercise booklet for people on dialysis that starts out gradually with exercises she can do sitting down. You can find this booklet under free materials for the booklet on exercise for people on dialysis.
After reading your reply I’m pretty much depressed with our country’s doctor. My mom’s doctor didn’t told anything what you have just expalined, he just gave us a small prescription to eat everything and make tastes after one month of Hb%, S. urea, S creatinine, S.electrolytes,S.calcium. Fortunately your explanation fits exactly to my mom. just a moment while I looked back all of her test report but there was no albumin tasting report. I guess doctor has never done it.
I’ll check the albumin level after 10 days, it will be a month then meanwhile I’ll check the Diet.
t is true that her heartbit is to much fast and some times it makes harder for me to check the exact BP level. Today it was 110/75. We happen to give her a banana dailly besides other fruits. It’s highly potassium food and I never knew this matter.
She’s is litle bit anemic too. We are giving her iron tablets but I didn’t understand EPO what’s that?
I’m checking the addresses you provided.
Thanks for your appreciation