Low blood pressure...they want to stop dialysis...please any advice is needed

[ChrissyJames]

My mom’s doctors are now saying that her blood pressure is very low, likely due to all the infections she has been fighting off. She has been on dialysis since her kidneys haven't been functioning properly because of an autoimmune disease. They can’t treat the disease due to her infections...and it seems as if when one infection begins to clear, another one arrises. They’ve been giving her medicine in high dosages for her blood pressure, but they’re concerned if they keep her on it, she could experience heart failure. They say they want to without dialysis because that would help boost her blood pressure some but her kidneys don't work so won’t this hurt her in the long run?? I don't know what to do. She was showing signs that she was improving from the pneumonia....and they said they will continue to treat her infections and other problems but they want to stop dialysis. Does anyone have experience with this? She was previously on continuous 24 hr dialysis and then adjusted to 10-12 hr dialysis. I mentioned what if they gave her fluids to supplement her blood pressure but they said the amount of fluids she would need would cause respiratory failure...

[Adr312]

I'm sorry your going through this.. my father was in the same situation.. maxed out dose on blood pressure medicine and on continuous dialysis. Swollen body from all the fluid. I don't think they have room to do much more in this situation. I wish your loved one improves. Its definitely possible but the wait is really painful..

[ChrissyJames in reply to Adr312]

Yes, it’s the waiting that has me so nervous and anxious. They’re not sure yet when she would be able to start dialysis again. For the most part her blood pressure has been fine, but she has had multiple infections so they believe that is the root of her low blood pressure right now. Thankfully they were able to clean her blood well before this issue arose, which should allow her more leeway to go without the dialysis...we are praying her blood pressure stabilizes so she can continue dialysis. Thank you so much xx

[RockRunner]

Hi Chrissy, there is a maximum amount of nova adrenalin they can give to sustain the blood pressure enough to pump the oxygen around the body to support the vital organs. This happened to my husband and they said he would go into organ failure and not make it, the next day he made a slight improvement and they could slightly reduce the dose (3 months later he has made it). The kidney are less important at this stage. Usually they will stop dialysis / filter when circuit needs changing to see if kidneys restart and they can leave them off it until their toxin / potassium levels get to a stage that then makes it dangerous. So I would suspect a few days off the dialysis is less of a concern than the fact that if the BP drops too low the vital organs won’t get oxygen and will fail. Ask how long they want dialysis removed. Living with kidney failure is a better option than not making it but also the kidneys are the last to recover after serious illness so it’s almost the least of their worries at this stage. They need to do whatever they can do to keep her alive long enough to the body to recover. Keeping everything crossed for you xx

[ChrissyJames in reply to RockRunner]

Thank you... they mentioned that her potassium levels are normal and her blood is clear of the toxins she first had when initially admitted. Her kidneys are just barely functioning, and she is only able to produce a little bit of urine on her own. They’re not sure when they will start dialysis again...it will just depend on when her blood pressure stabilizes more so that her body can handle it. I am praying it rises within the coming days. They said the same thing about my mom. If she continues dialysis at this point, it would trigger multi-organ failure so this is what they must do to avoid that. I’m so happy to hear that your husband has made it 💕

[RockRunner in reply to ChrissyJames]

Her kidneys sound in a better place than my husband’s so very good chance they will recover in the longer term. Don’t worry about them right now they tend to get better when the patient gets better and usually the last thing to recover. Blood pressure much more critical at this stage x

[ChrissyJames]

An update: my mom still has not had dialysis. Her blood pressure during the day is usually around 120/47 so her diastolic pressure is low...she is still receiving a little bit of medicine to increase her blood pressure. They have identified a new infection that they believe is the cause of her blood pressure dropping because she also developed a fever the day her blood pressure went wonky and for a 2 days after that she had a couple low grade fevers. For the last three days, her temperature is around 37.4. They started her on the proper antibiotics yesterday (once they were able to identify the specific bacteria, prior to that she was on broad spectrum antibiotics). She is still awake and responsive to commands. In addition to new infection, she is also currently still dealing with pneumonia. Thankfully, her ICU doctor said that is steadily improving...We spoke with her kidney doctors yesterday, and they still aren’t comfortable starting dialysis yet. I know there isn’t a specific timeline for these kinds of things because it varies from person to person. Depending on circumstances, the amount of time one can go without dialysis varies...I just wonder if anyone may have some more insight on this. Thank you all, as always. Xx