Vitamin/Mineral Loss on Dialysis

Bill_Peckham · December 10, 2004, 3:40pm

Hmmm…I’ve gotten confused. How many liters are in a bag? If you’re using a dialysate flow of 60 ml/minute then you need 7.2 liters for a two hour run right? I guess I’ve never heard of dialysate flows that are that low. I guess I don’t understand the impact of such a low dialysate flow rate. I’ve always thought that dialysate flow should be greater than blood flow.

Gus · December 10, 2004, 4:20pm

Bill_Peckham · January 3, 2005, 5:50pm

Gus - how about an update? How are you feeling these days? What treatment schedule (length/frequency) did you settle on?

Gus · January 3, 2005, 7:07pm

[b] Hi Bill, good to see you again!..It’s a brand new year and am really excited…can’t wait to see 2006!..hehe

Anyhow, am feeling great and hypersensitive reactions seem to have disapeared…

There were a few changes I did which include not taking ACE inhibitors, heparinless treatments, and flushing the lines and dialyzer with 600 saline fluid…

Somehow, the long term dialysis I’ve had caused my body to develop some antibodies which in turn causes hypersensitive reactions to some material particles so flushing the lines/dialyzer helped alot…the Heparin and ACE inhibitors contributed in increasing the degree of the reactions so stopping those was a feasible step in preventing any further problems…

Still am armed with Benadryl liquid 12mb…in case any reactions happen again…since 23rd December I have not taken any Benadryl so it seems we’ve nailed this time…

I also take Nepro for supplements…now and then I also take Whey protein powder…in addition to Dialyvite tabs…

So far so good and am really happy…

I hope your doing well and c’mon now you have to try NxStage…

[/b]

system · January 4, 2005, 10:49am

Hey Gus,
Can you say more about this flushing technique you are using minus heparin? How often do you flush and with how much saline? Do you add to your goal for saline used from the beginning of tx? Who gave you this idea? I would be interested to know if it improves your clearance and if you feel better from eliminating heparin.

system · January 4, 2005, 11:00am

Gus wrote:
No, it does not have sodium profiling or where you can give yourself sodium…the dialysate has the normal amount of sodium an average person maintains so it’s maintained throughout treatment, now if you need more then you’d use the saline shot…

Please explain this statement. What do you mean by “saline shot”?

system · January 4, 2005, 11:01am

Gus wrote:
No, it does not have sodium profiling or where you can give yourself sodium…the dialysate has the normal amount of sodium an average person maintains so it’s maintained throughout treatment, now if you need more then you’d use the saline shot…

Please explain this statement. What do you mean by “saline shot”?

Gus · January 4, 2005, 11:28am

Jane:

Hey Gus,
Can you say more about this flushing technique you are using minus heparin?

This is something I’ve requested and done on my own research…I’ve been on dialysis for over 20 years now and being on for a long time and/or sensitive patients may have or develop antibodies which in turn cause allergic reactions to any substance or matertial from the dialyzer and/or lines…Heparin use for a long time may also trigger antibodies which also contribute to the hypersensitive reactions…it also has been found that blood pressure medicines based on ACE inhibitors also cause problems in some patients…

How often do you flush and with how much saline?

First I need to prime the lines to get all air out…then once in recirculation I stop machine and throw out the saline bag used for priming…finally, I add a new saline bag and use only 600 to flush out the lines/dialyzer…the remaining 400 is used to terminate treatment…this only applies to NxStage machine, I’m sure the approach can be done on other machines but the steps may differ…I assume flushing the lines with more than necessary saline will give better results…I’ve went from using 750/750=1500 down to 600 only…the NxStage machine only uses about 600 for priming…

Do you add to your goal for saline used from the beginning of tx?

Yes, I add .3 to my goal…rinseback that is…so for say my weight was 58.0kg and my dry weight is 56.0kg then I’d have 2.0kg to remove but add .3 to 58.0kg divided by 2.5 hours plus .15 equals the UFR I need…

Who gave you this idea?

It’s based on research and information provided by research studies and trials…and by request…I had to request these changes to resolve the issues I was having…it’s something you have to workout with your Doctors and Nurses…you can also research on your behalf by searching the net for information, but the staff and Doctor should be aware of the situation…

I would be interested to know if it improves your clearance and if you feel better from eliminating heparin

Time will tell and have already eleminated heparin for quite sometime now…I’ve substituded heparin with baby asprin…worked well for me…dialyzer has been looking well and pressures are very well…for NxStage, max is about 300…mine averages at 185-210…I could also use saline flush every 30min but didn’t have to do that…

.

Gus · January 4, 2005, 11:33am

Hehe, sorry I confused you… …it’s my medical street slang word for bolus infusion… where you normally give yourself saline but not as a shot like a needle shot…hehe