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Peritoneal Dialysis
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lynettestarr1 posted:
My 81 year old mother just started PD at home about 3 months ago. I am her caregiver and am blessed to be. However, it is unsettling when her Ultra-Filtration (UF) number is lower than her "fill" number. I always feel that she is retaining the waste products, which would make her ill. She still has some kidney function, but I do not believe it is filtering waste products any longer, as her urine is usually clear. Does anyone know how I should expect the numbers to go, meaning - if her UF is equal to or more than her "fill", should that be fine? Should I worry when the UF is lower than the "fill"?
I appreciate any information. I want to know that I'm doing what's right for her. Her doctor says if she equals out, she's fine. I have a hard time believing that.
Thank you.
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mrscora01 responded:
While I was initially trained on pd, I was never able to do it (pain issues). If she is feeling ok I would trust the doc and not obsess about every number. I know that periodically they check the fluid coming out to make sure that exchange is still working properly. Have you had that test? Sorry I can't be more help.

Cora
 
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john-skpt responded:
It's hard to guess without the kT/V or URR numbers, and without tracking her weight over the long term.

You need to remember that the peritoneum is not a "one-way" system: a fair amount of fluid can diffuse IN as well as OUT. If she is still producing some urine, even if it doesn't have all of the waste material in it, then that fluid is going out.

So you need to look at a lot of different numbers and base judgments on that set of things, not simply on the ultrafiltration.
 
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lynettestarr1 replied to mrscora01's response:
Thank you Cora. My mom does have pain, but it's because the surgeon had to place her sensor to the side of the usual placement. He has discussed another surgery with her, to stitch the sensor in place, but he also told us that the surgery is a risk for infection that would be best put off unless absolutely necessary. She has put it off so far and the pain has lessened in just the last few weeks.
She has had that test, but I didn't hear any results, and I thank you for reminding me that I need to call her Nephrologist and find out what they know from it.
Thank you for your input. Any discussion is helpful, trust me.

Lynette
 
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lynettestarr1 replied to john-skpt's response:
Thank you for your response, John. Mom's weight was remaining pretty steady, with up to four pounds difference once in awhile. We were told that anything over three pounds had to be brought to the attention of the dialysis nurse, which we have done. They had her come in and after checking her over, determined that she was doing fine. Right now she is five pounds more, but she has been eating better lately, which is a relief.
So, I need to look at kTN or URR numbers. At the risk of sounding ignorant, where do I find these numbers? I do get the results of her lab-work every month, but I haven't seen those numbers on those read-outs.
Thanks again for responding.

Lynette
 
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john-skpt replied to lynettestarr1's response:
It's been quite a few years since I did HD then PD, but if i recall correctly, I would periodically save a days worth of used dialysate, take it in to the office for my checkup, and they would test the solution and do some math to come up with a number. (For hemodialysis they drew blood before I went on the machine, then after, and calculated from those samples.)

http://en.wikipedia.org/wiki/Kt/V

So I'm not sure exactly where the number would be, but probably not on the same sheet with blood test numbers. It might also be under some cryptic heading like "adequacy".
 
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lynettestarr replied to john-skpt's response:
We have submitted the used dialysate once, but the results were not passed on to us. Thank you for that information - we will bring that up in the next check up in a week or so.


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