Swelling...Any Suggestions?

I’ve been having an odd problem with swelling recently. I am on the cycler and use mostly 1.5% bags of fluid. I use a 2.5% about once a week +/-. That usually works for me, but since I shortened my dwell time, I seem to not be able to get all the fluid off, and when I do get it off, I just absorb it back the next night. Here are my stats for the past week:

Sun: weight=136.0 lbs (61.69kg); BP=118/66; UF=399mL with 2.5%

Mon: wt=137.4 lbs (62.32kg); BP=119/68; UF=213mL w/1.5%

Tues: wt=136.2 lbs (61.78kg); BP=131/79; UF=108mL w/1.5%

Wed: wt=138.4 lbs (62.78kg); 4got2doBP; UF=140mL w/1.5%

Thu: wt=138.0 lbs (62.60kg); BP=122/68; UF=-101mL w/1.5%

Fri: wt=138.2 lbs (62.69kg); BP=122/70; UF=-341mL w/1.5%

Today: wt=137.6 lbs (62.41kg); BP=123/81; UF=484mL w/2.5%

Looking back on these, I’m starting to think that maybe I’m just drinking too much? I haven’t really been keeping track of how much I’ve been drinking. I do still urinate, and I have been doing that a lot more too. Any suggestions/ideas as to why I keep swelling?

Also, it all stays in my legs, mostly my left leg, where the blood clot used to be. If I sleep with my feet up, I seem to get a little more off, but it’s not very comfortable. lol

I’d definitely suggest that you ask about how much your fluid limit is and try to stick as close to that as possible to see if that makes a difference. Talk with your home training nurse about your concerns. Show him/her your treatment data. Ask what you can do to reduce the extra fluid in your body and the pooling of fluid in your leg(s).

Your doctor and nurse will probably want to review your dialysis prescription. They may want to to a peritoneal equilibration test if they haven’t done one recently to see if you’re a slow or fast transporter. This could affect whether you absorb fluid. You may need a different dialysis prescription.

If your albumin is low (PD removes a lot of protein), this might affect how well your dialysis removes fluid. It’s important to eat a healthy diet that includes enough protein to keep your albumin at 3.5 or above (4.0 is better). If your albumin falls below 3.5, this puts you at risk of infection and hospitalization.

I’d also think that it would be a good idea to review your medications, including any herbs or supplements that you take that your dialysis clinic may not know about. Medications can have the side effect of fluid retention.

Hey, thanks for answering. My fluid restriction is 2L/day. I used to not drink enough, so I started eating salt again. Recently, I have been doing better about drinking the whole 2L, like they want me to do, but eating salt again is what I think is making me retain. I talked to my DR, but he usually leaves this kind of stuff to me and my nurse. He’s busy trying to get me a transplant right now, which I totally understand.

We just changed my Rx from 11 hours a night to 9 hours a night, still with 3 dwells. I used to not have a last fill, but bc it caused me to bleed occasionally, I now have a last fill of 700mL.

My albumin is 4.1. I try to get it as high as I can, but I am just not into meat and eggs and those protein supplements. I do keep it just high enough though. :slight_smile:

All of the meds I take are Rx from the neph. I never take anything else without asking first. I don’t even take Tylenol unless I absolutely have to. My outlook is that I take enough meds as it is. I don’t want to take anymore, unless I absolutely have to! lol

What I decided to do about the swelling is cut back on the salt and try not to drink over 2L/day. That should help, but if not, then I will talk to my DR and nurse again.

Wow – You are being told to drink more! The patients I worked with when I was in the dialysis clinic were limited to 4-6 cups of fluid per day plus the amount they urinated. Having to drink 2 L of fluid a day is a lot!

Your albumin is great, especially if you don’t like meat and eggs. You must work hard at keeping that up.

You say you’re leaving 700 ml in during the day. I wonder if you’re absorbing that 700 ml. Is your dialysis prescription set up to take that into account along with the 2 L of fluid you drink?

I suspect salt could be causing you to retain fluid. However, it might also be good to ask your doctor/nurse if any of your meds cause fluid retention too?

If the swelling is in one leg more than the other, I might ask the doctor to check the circulation in your legs (doppler?), especially since you had a blood clot there before. Be sure to regularly feel and look at your legs to see if one is cooler or paler than the other. That can be a sign of a circulation problem.

Yeah, 2L a day. My nurse said it’s bc I’m a PD patient. There’s a home hemo patient I talk to on another site who has the same limit as me. It’s bc we dialyze every night for at least 7 hours. The in-center patient I talk to has a limit of 1L a day, since she goes every other day. I figure it’s like 2L before each dialysis treatment, you know? lol

Yes, I leave 700mL in during the day. By the end of the day, I average about 300mL drainage out of that 700mL. I don’t absorb all of it, but I do absorb a little. I think it’s more of me drinking too much and eating so much salt.

I told my DR that the swelling in that leg never goes down really. I had the blood clot in the main artery of my leg for 3 years before it went away. It started above me knee and went almost to my heart. Bc it was restricting the blood flow so much for so long the smaller veins in my leg had to do it’s job, and they got bigger as a result. So my DR said that bc it was like that for so long it will always be like that; a little bigger than the other leg. I think that it’s more fluid…I’m just going to try less salt and fluids and see if it helps. If not, then I will talk to him again, and let him know that it’s fluid, not blood.

I definitely know what a blood clot feels like and what the signs of a blood clot are! lol They hurt!!

I’m not swelling as bad now! It was from too much salt. The only reason I started eating salt again was bc I kept getting dehydrated. The shorter dwell time changed it so that I can’t have as much salt as before. lol Strange how little things like dwell time can make that big of a difference!! :stuck_out_tongue:

I’m glad you found a solution, Shay!