I'm 58 yrs old and I have been on PD for a little over 3 years now. At first, there were no issues whatsoever. In Oct of 2018, I had to have both kidneys removed due to size (polycystic). After surgery, I had no real drain issues and easily slept thru the night. The past year or so, my draining has seemed to stop too early. (I do 5 fills of 3100) My machine practically just stops everything at around 2800 and I have to stand up for every drain, starting at around 2300. I've gotten used to having to stand, but as I have to leave 500ml plus any UF, it accumulates, as you can guess, and by morning (10hrs) I am miserable! So, I've had 2 surgeries this month to look for adhesions and drain issues with no real results. I start hemodialysis in 2 days, but still searching for any help or solutions to try to get my PD going again. I feel like it's in the cycler "pump" that does the draining, but all my Dr's and nurses say it's me. They are saying my membrane has stopped working, but I'm still accumulating too much fluid per fill for that to be correct. They won't even let me try a new cycler. I'm looking for ANY help to stay off hemodialysis as long as possible. I'm about to go over their heads back to the medical university that did my removal surgery! SUGGESTIONS PLEASE??!! Thanks in advance!!!
Is there any fibrin in your fluid? Sometimes there is a “jelly” fibrin. Maybe some IP heparin would help. You could also ask the nurse to test your cycler in the clinic and run it through your rx on a “dummy tummy” to see if the problem replicates. I would also insist on a cycler swap since this problem is causing you to have to change modality. I would start the grievance procedure if they decline to swap it out. Make sure you are using a good bowel regimen. Even if you don’t feel constipated, a slow movement of stool through the colon can shift the position of the catheter. You could also ask about a KUB xray to check for PD cath placement. If it has shifted you may need a manipulation (if that isn’t the surgery you already mentioned). And you can always do another PET test to see if you really do have membrane failure. I’m thinking you may need a shorter PD cath now that your large kidneys have been removed. The tube probably kinks now that your abdomen is smaller. It might be worth it to try HD and let your abdomen rest then try another PD cath in 6 months.