Questions-New to Dialysis

Our family is new to all of this as my dad had a temp cath placed in his neck this past Saturday. He received his 1st dialysis at the same time and will have his 2nd one tonight. I don’t know all of the terminology, but hopefully my questions will make sense.
1st - He has been very weak for a few weeks now. How long does it typically take for your energy level to go back up? Will it return in full or does it depend on the patient?
2nd - He has lost about 15 lbs (I think) in the last 2 weeks and does not have an appetite, when will it return?
3rd - He has had very strong urges to urinate (he says they are painful) but is unable to go. He gets the urge about every hour and can only go a little. Is this normal? Any ideas as to why this is happening?
I am so glad to have found this board, and hopefully someone out there can help.

Hi Tara,
I’m glad you found our website too. It sounds like your father may be on hemodialysis instead of peritoneal dialysis. If blood is out of his body while dialysis is going on, his treatment is hemodialysis. If no blood is out of his body while dialysis is going on, his treatment is peritoneal dialysis. If he is doing hemodialysis, you might want to post your message to the hemodialysis message board for patients.

In the meantime, I am not a patient, but am a social worker with years of experience working with patients with kidney disease and kidney failure. It can take several treatments to remove toxins that have been building up in the blood. The length of time between when someone starts dialysis and when they start feeling better can be from one or two treatments to a month or more, depending on how sick the person was when dialysis started.

You may find that your dad loses more (fluid) weight in the first few dialysis treatments making his total weight loss more than 15 pounds. When someone’s kidneys are failing, they may lose their appetite and feel sick at their stomach. Patients often say that meat had a metallic taste. Generally food starts to taste better once toxins are removed. This allows the appetite to return. Talk with the dietitian about what foods your dad should eat. He’ll need plenty of high biologic value protein to get his muscles working again. If he’s anemic (low hemoglobin), he will need EPO (Epogen or Aranesp). This should help him feel stronger and more energetic.

If he is weak and it limits his self-care activities, ask for a physical therapy referral. It’s best if he goes to the rehabilitation program where he can be taught and monitored while using their equipment, but if he can’t get there, a physical therapist should be able to come to his home to give him treatments. Progress is usually faster when therapy can be done at the rehabilitation site because the therapist doesn’t have the same equipment available in the person’s home.

So far as the desire to urinate and pain that he feels when he goes, he should report this symptom to his doctor right away. It may mean that he has a bladder infection and needs antibiotics.

Check out the modules on Kidney School ( They may help answer some of your questions and give you other questions to discuss with the kidney specialist.

Hi Beth-
Thanks for the reply and the info. I believe that you are right in that he is getting HD right now. Because I wasn’t sure yesterday, I posted in both places.
It is funny that you mentioned the funny tastes, I do remember him saying that he constantly had a funny taste in his mouth but couldn’t describe it (he thought it was from a medication he was on for a viral syndrome), maybe it was really the toxins in his body. He talked with the dietician last night and she gave him lots of info. He is processing through that (and about a million other things) and hopefully he can get eating and gain some energy back. Your info on getting PT (and the deconditioning) made sense too, I will pass that on to him. I think it would be easier if we had some warm weather here, he might get out and take a short walk, but it has been very cold and he is always very cold - even inside. He mentioned the urination issue to a nurse at the office and she said that some people still have to urinate. I don’t know if she said anything about the pain. Today he seems to think that he may have pressure from needing to have a BM as he hasn’t gone much since just after his 1st dialysis.
Thanks for the kidney school link, I was there yesterday but didn’t commit much time there. I will go back and do some more hunting.
Thanks again!

Hi Tara,
It’s overwhelming isn’t it! My kidneys failed April 12,2004. I’ve been diabetic for 22 years. I am 40 now. I started feeling better in about 2 months, but on my dialysis days, I still feel bad after I get off the machine. (I’m on hemo now). I have problems putting on too much fluid between treatments, therefore I just had a PD tube put in my belly. In fact, I just had it done yesterday and am very sore right now. I’m hoping by doing my dialysing at home every day, I won’t put on as much fluid as I do now.
My appitite came back in about 3 weeks, after the toxins were removed for a while. It will take some time to get your dad’s “dry weight” set and then he should start feeling better. Just to warn you, I have trouble with my blood pressure dropping towards the end of my treatment. Of course, the more fluid they have to remove, the more problems I have. It takes some getting use to, but things will get better. The best advice is to follow the clinic’s instructions and watch the fluid intake. If your clinic is like mine, there are staff there more than willing to help your dad get things on track. Good luck and God bless you both.

Hi Everyone,

My brother has just staretd the PD treatment. The Cather was placed yesterday and treatment started yesterday. He has not eaten in weeks and even after treatment. He says he does not feel hungry. He also has started having hicups that dont go away no matter what we try. He is very weak and has no energy. Can you please advice on the following:

1.When will his appetite come back?
2. When will he gain more energy?
3. Does the hicups have anything to do with the treatment.

Please help, thanks.

When someone has failing kidneys, wastes build up in the blood. As kidneys fail more and more wastes build up in the body, people start to have symptoms. Some symptoms may start when kidney function drops to 50%. More symptoms appear and they increase as kidney function continues to decline. It sounds like your brother is experiencing some of the more common symptoms of kidney damage/kidney failure. These include such things as bad taste in the mouth, nausea, vomiting, ammonia breath, tiredness/sleep changes, lack of energy, and even hiccups. Typically the more wastes that are removed from the body, the better your brother will feel and the fewer symptoms he will have.

It’s important for your brother to report ALL of the symptoms that he experiences to his dialysis team – his home training nurse, doctor, dietitian, and social worker. Each of them can work with him on helping to reduce the symptoms that he’s having. For example, the home training nurse should draw blood samples for testing to see how well PD is removing toxins, whether he has anemia (a common cause of lack of energy, fatigue), whether he’s malnourished, and whether he’s on the best type of PD for his body and how it transfers wastes. The doctor can prescribe medications if his symptoms and labs indicate that he needs them. The dietitian can help him understand his new diet and how to incorporate as many of the foods he likes in his diet. Although he may have been told to limit protein before starting dialysis, being on PD requires patients to eat more protein than before or even on hemodialysis because PD removes more protein than hemodialysis. Muscles need protein to function normally. The dietitian can advise him on how to get the protein that he needs. The social worker can work with him to monitor how he’s feeling emotionally related to having kidney failure and requiring dialysis as well as talk with him about how he can get back to doing most, if not all, of the activities he enjoys doing. Depression is very common in those who are new to dialysis and depression can affect appetite, energy, sleep, sexual functioning, and much more.

You and your brother may want to look at Kidney School, which includes 16 “modules” (topics) related to living with kidney disease. There is a module on how kidneys work, lab tests, nutrition, coping, and much more.

He may have animia. Ask the doctor if he needs to be on procrat

Blood test will show if someone has low hemoglobin (Hgb) or hematocrit (Hct), which are signs of anemia. Anemia is common in people who have kidney damage or kidney failure. Drugs such as Epogen or Aranesp (injected or IV) and iron (IV or oral) are given to anemic patients on dialysis when their Hgb is less than 10 mg/dL to raise the Hgb to between 10 and 12 mg/dL. Procrit is the same basic drug as Epogen, but sold by a different company to doctors to give to patients not yet on dialysis. These drugs have a warning on their labels about certain risks associated taking them when the Hgb is above 12.

It’s been a few months since your brother started on PD. How is he doing now?