When dialysis is working too well

The ultrafiltration of 1166ml is the highest amount of water drawn from my body using two 1.5% peritoneal dialysis solution.

The uf (ultrafiltration) for this morning was 1166ml. That is the amount of water pulled out from my body at the end of peritoneal dialysis.

Apart from losing the ability to filter waste from my blood, my kidneys are no longer able to draw out water as well.

Water retention will manifest in swelling of the feet and ankles. In severe cases, other parts of the body will swell too.

It can accumulate in the lungs causing shortness of breath. Excess water can also cause an increase in blood pressure.

In peritoneal dialysis, 2000ml of solution consisting of dextrose and other electrolytes are filled into the peritoneal cavity. It then dwells in the cavity for 1 hour 34 minutes where waste and water are pulled out from my body through osmosis.

The solution is then drained and fresh solution is filled in. This process is repeated five times within a period of 10 hours. At the end of the entire process, 10 liters of solution would have been used.

Any extra in the solution is water taken out from my body. The usual amount ranges between 600ml to 900ml.

This morning’s was the highest using two bags of 1.5% solution since I started dialysis in August 2018. Add that to the 900ml of urine my kidneys still produce daily and the total water taken out would nearly hit 2000ml.

Dialysis is so efficient that the doctor said I may be dehydrated. That was the reason I have been experiencing low blood pressure lately.

To prevent dehydration and bring up my blood pressure, I have to replenish with the amount of fluid that came out plus 500ml more.

On normal days now, I drink about 2 liters of water. This is a small luxury since most people with kidney disease have to limit their water intake. Some are restricted to no more yhan 500ml per day only.

Celebratory lunch

Chili’s Classic Ribeye

Lunch was steak! Testing my allergy to beef. And also because I need to increase my dietary protein. 10oz of grilled ribeye. Replaced the loaded mashed potatoes with another serving of broccoli. Potatoes are high in phosphorus and bad for kidney disease.

This lunch is also in part because of the outcome of my scheduled medical check up this morning. Blood test results showed improvement. Hb and serum iron is within range. Micera is now reduced to 50mcg every 6 weeks from every 4 weeks; Calcitriol every two days from daily.

I’ve been hypotensive lately probably due to dehydration related to peritoneal dialysis. Amlodipine to control my hypertension is stopped. I’m allowed to drink up to 2,000 ml water daily to counter that. Besides, I’m still producing a good amount of urine and my uf is averaging 800ml.

I’m thankful for small mercies like this. Going to enjoy the moment because I know it will not last.

Unproductive days

I have been feeling lightheaded on and off recently which I attribute to hypoglecemia. That is exacerbated by occasional hypotension related to peritoneal dialysis. I was advised by the doctor to stop taking amlodipine, the medicine to control my hypertension.

Nevertheless, the convergence of these two symptoms in the past few days have made me listless. The current hot spell is not helping either. I cooped myself up in the bedroom with the air-conditioner at full blast almost the whole of yesterday.

I had to drag myself out of bed today because I felt that the more I slept the more listless I would become. Even then, I have not been able to do much. Hopefully, this will go away soon and not symptoms of something more serious.