Rallph's Blood Results

Hi all,
Went to clinic today and the Dr. was thrilled with the results.
Doing nocturnal 6 nights a week for 7.5 to 8.5 hrs per night, FF% 33, Dialysate 60L, his pre bun was 47 post bun was 22 his spkt/v was .95 his ekt/v was .89 and stdkt/v was 3.91. His Phorphorus was 4.1 (no binders) his potassium was 5.2 but had eaten stuff with a little higher potassium the day before.
So you all can see he is doing great! He feels better and is not as thirsty as on the Freni. So I do not have to take as much off each night.
So What do you all think?
We are thrilled!
This makes it all worth the small effort I put in. ( Not like the effort I had to put in using the Freni and RO)
Pat

[QUOTE=Pat Colongione;11542]Hi all,
Went to clinic today and the Dr. was thrilled with the results.
Doing nocturnal 6 nights a week for 7.5 to 8.5 hrs per night, FF% 33, Dialysate 60L, his pre bun was 47 post bun was 22 his spkt/v was .95 his ekt/v was .89 and stdkt/v was 3.91. His Phorphorus was 4.1 (no binders) his potassium was 5.2 but had eaten stuff with a little higher potassium the day before.
So you all can see he is doing great! He feels better and is not as thirsty as on the Freni. So I do not have to take as much off each night.
So What do you all think?
We are thrilled!
This makes it all worth the small effort I put in. ( Not like the effort I had to put in using the Freni and RO)
Pat[/QUOTE]
Great News Pat & Ralph

I’ve been following your posts and I’m now more than before going to try and see if I can get a try on nocturnal in the spring.
One question What is " his spkt/v was .95 his ekt/v was .89 and stdkt/v was 3.91" ?

Thanks for keeping everyone up to date
Best to You Both
bobeleanor

[quote=bobeleanor;11543]Great News Pat & Ralph

Glad to hear things are better. Why do you suppose Ralph isn’t thirsty as much?

Erich

How’s his blood pressure?

I’d speculate that he’s not thirsty as much either because he probably has no fluid limit, with 6 nights/week nocturnal–so he can drink if he’s thirsty, or because he’s not getting “sodium modeling”, which tends to leave people sodium-loaded–and thirsty.

Hi Pat,
Re potassium, would you say he has been eating all the potassium foods he wants or does he have to watch it? And, I think I asked before, but have forgotten-is the pureflow solution lactate based like the bags? Do you think lactate =less thirst or is it the fact that sodium modeling is not used?

Well, Not really sure what each of KTV’s are but will ask and let you all know.
The thirsty thing is just as Dori had said. On the Freni we did sodium modeling. As for the potassium he eats what every he wants (although he should be watching more because of diabetes) and drinks what ever he wants. The Dr. and the Nurse said he is doing so well because we do 6 nights. If I could I would do the 7th night as well. I find using the Nxstage and Purflow a breeze. Don’t know if the purflow is lactate based but I would think it is the same as the bags only with out the water.
bobeleanor, why wait til spring? Start the first of the year!
God Bless this group. You all are wonderful!!!
Pat

[quote=Pat Colongione;11542]Hi all,
Went to clinic today and the Dr. was thrilled with the results.
Doing nocturnal 6 nights a week for 7.5 to 8.5 hrs per night, FF% 33, Dialysate 60L, his pre bun was 47 post bun was 22 his spkt/v was .95 his ekt/v was .89 and stdkt/v was 3.91. His Phorphorus was 4.1 (no binders) his potassium was 5.2 but had eaten stuff with a little higher potassium the day before.
So you all can see he is doing great! He feels better and is not as thirsty as on the Freni. So I do not have to take as much off each night.
So What do you all think?
We are thrilled!
This makes it all worth the small effort I put in. ( Not like the effort I had to put in using the Freni and RO)
Pat[/quote]

Geez, am not sure but were these numbers the same as when on Fresenius? How about blood pressure? Is blood pressure the same as when on fresenius?..As for the thirst, that thirst problem has to do with “Sodium Modeling” that they use in-center…from the numbers you posted that’s typically what dialysis patients should have to be safe…

My husband is on nocturnal as well 5 nights a week on Fresenius 2008 with an RO. Nocturnal is really new here. I am not familiar at all with the nxstage but it sounds good. Will probably be years before it is available here. About thirst when we were training my husband told the nurse that he didn’t feel as thirsty as he did in center. She said that it was because he was getting more adequate dialysis so he wasn’t as uremic. He always found he was thirsy on the last day of his 2 day break. His blood results were really good last week as well. Creatine and BUN were normal or below normal post. Phos was 1.54 pre which is almost in normal range and 0.58 post which is below normal. Not taking any binders and eating most every thing that he wants. Gaining lots of weight!! He is really almost 6 foot and 160 pounds so he can gain a little weight without any worries.

Good point–I hadn’t thought of that. Uremia can trigger thirst, because there is less water in the blood, and also comparatively more solutes (dissolved wastes). You can read about thirst on Wikipedia, at http://en.wikipedia.org/wiki/Thirst.

It’s ironic that in-center HD both causes more thirst due to sodium modeling (one of the only ways to reduce the symptoms of removing a LOT of water FAST) and also leaves people more uremic so they get thirstier. It hardly seems fair.

My husband would never let them ramp(that’s what they call it here)his sodium. He was never a big fluid gainer and had no trouble taking off the fluid. One nurse did it a couple of times without him knowing or so she thought but she was told never to do it again. He told her he didn’t want any thing done to make him thirsty when he didn’t need it done.

I guess the doctor and nurses were not sure that Ralph would get as good a dialysis on the Nxstage as the Freni. This just proves it is possible for a person of his size to use NXstage nocturnal and get the same results.
Pat

Delphine,

NxStage wasn’t available in East Lansing, Michigan until I sought it out. DaVita @Home provided it in other Michigan cities so I told my nephrologist that this was what I was going to do. She then got credentialed and I am her only patient currently on NxStage via DaVita @Home. Her other patients are either PD or in-center via a Fresinius Center in town. Perhaps this will work for you. Good luck, Erich