My Dad started APD and got rid of about 5kg fluid initially with good UFs of 600-800 mls whilst on 250mg of furosemide a day. Once weight was down and stable though, the UF tailed off, so the furosemide dose was halved with a view to the dialysis removing the fluid rather than the furosemide. However, over the next 3 weeks the weight crept back up so he's back on the 250mg furosemide, this is starting to resolve weight but the UF isn't great, 300mls on a good day but usually around 150 mls. I am wondering 1) if the fluid removal from the dialysis is poor will it still be adequately cleaning his blood? 2) is it usual or uncommon to still need a highish dose of furosemide to maintain stable weight/fluid balance on APD? 3) if anyone has any suggestions which might improve the UF and reduce the need for furosemide, I'm assuming that is what's needed/best as the consultant had intended to halve the furosemide.
Dad has 5L yellow, 2.5L green, 2.5L blue, leaving a day dwell of 1.5L purple.
He's tending to get low drain alarms on his 2nd and 3rd drains lately too.
Ideas info and suggestions will be welcomed as I plunge into this forum for the first time!
APD and furosemide dose
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Re: APD and furosemide dose
Hi Alf,
1) Dads blood results will show if his blood is being cleaned.
2)Yes, but everyone is different.
3)I would suggest you ask the consultant/PD nurse, they will be happy to answer your questions. You will have to get dad to tell them it is OK to discuss his case with you first.
This page will give you some information, the site is very good so worth a look around. http://www.edren.org/pages/edreninfo/bl ... isease.php
Best wishes to you and dad.
1) Dads blood results will show if his blood is being cleaned.
2)Yes, but everyone is different.
3)I would suggest you ask the consultant/PD nurse, they will be happy to answer your questions. You will have to get dad to tell them it is OK to discuss his case with you first.
This page will give you some information, the site is very good so worth a look around. http://www.edren.org/pages/edreninfo/bl ... isease.php
Best wishes to you and dad.
Re: APD and furosemide dose
Alf,
I would talk to your dads nephrologist.
When I started APD I was told that My renal function would carry on deteriating and that over time my own kidneys wouldn't clear fluid as well and I would eventually require fluid restriction. (I have to admit it all sounded rather depressing). As Frusomide acts on your kidneys to encourage fluid loss, you do need some renal function for it to work. Is your dads native renal function getting worse? - hence the need to chat to the nephrologist for specific information relating to your dad. I don't know how long he's been on dialysis but we are all different and it's a balancing act as treatment is individualised for us.
Best wishes
Let us know how you get on
Sue
I would talk to your dads nephrologist.
When I started APD I was told that My renal function would carry on deteriating and that over time my own kidneys wouldn't clear fluid as well and I would eventually require fluid restriction. (I have to admit it all sounded rather depressing). As Frusomide acts on your kidneys to encourage fluid loss, you do need some renal function for it to work. Is your dads native renal function getting worse? - hence the need to chat to the nephrologist for specific information relating to your dad. I don't know how long he's been on dialysis but we are all different and it's a balancing act as treatment is individualised for us.
Best wishes
Let us know how you get on
Sue
Started APD July 2014
On transplant and paired exchange lists.
Transplant 9/5/15
On transplant and paired exchange lists.
Transplant 9/5/15
Re: APD and furosemide dose
Thank you, we have a good relationship with nurses and most of the consultants and they're happy to talk to me or dad as required. His eGFR is around 11 and not altering and he's been on PD since September. We'll talk it through a bit more with them into next week but he's not due any more bloods until March, which I felt was a bit of a long gap since the last ones were done mid December when his creatinine was still 460 and urea 20.4. Thanks for the weblink!
Re: APD and furosemide dose
Things much improved this week, after a few nights with 5L green bags instead of the yellows he lost weight/cleared the fluid . Now back on the yellow bags the UF is back up sufficiently to maintain weight without gaining. Swings and roundabouts and learning curves!
Re: APD and furosemide dose
Hi Alf,
That sounds much better for dada.
That does look like a long time between bloods, are they testing samples of used dialysate?
It is important to pass on (if dad doe's not) any information about his wellbeing, and weight changes, to his nephrology team. Silence is usually interpreted, all is OK.
That sounds much better for dada.
That does look like a long time between bloods, are they testing samples of used dialysate?
It is important to pass on (if dad doe's not) any information about his wellbeing, and weight changes, to his nephrology team. Silence is usually interpreted, all is OK.