CKD and blood clotting in veins

[keyesor]

My Niece aged 30 is having CKD and undergoing dialysis. When the Dr. tried to fix fistula in her hand it is not successful. Dr says blood clots in her veins, so he put a catheter in her chest . She is not having swelling in her body. she is passing urine normal. taking food sleeping well. No vomitting. Her blood pressure is low 110/70.

Hemoglobin is 8.8. What we should do to increase the blood pressure and stop blood clotting in vein so that Dr. Can fix the fistula in her hand.

I would be grateful to you if you give some suggestions.

K.Sethuramalingam

[Hidden]

Is there a reason you are asking non-medical folks this? All inquiries of this type must be directed at her physicians.

We wish her the best.

[keyesor in reply to Hidden]

Sir,

Dr is giving medicine . We are more anxious about her health. That is the reason I am asking it. If we are not supposed to ask questions like this in this forum then what is the use of this forum. Then all the members should ask their Dr about any doubt. Please tell me what type of questions we should ask in this forum.

Regards

K.Sethuramalingam

[Hidden in reply to keyesor]

We are not medical doctors. We offer no diagnosis. This community shares information and with each other regarding health issues surrounding CKD. Your daughter is under treatment for a fistula do to a failed graft. She is under the care of licensed and trained physicians and we have no knowledge of her specific condition and what treatment plan her doctors have ordered. It would be extremely inappropriate for anyone here to offer you advice when we don't know her.

We offer suggestions for people learning about CKD and how best to find resources and become proactive in slowing the progression of their CKD.

I'm sorry if that is not what you are seeking but she is under a physician's care. If you aren't happy or want alternatives to what the doctors are doing seek an alternative opinion from another physician.

[Jayhawker in reply to keyesor]

Since none of us are physicians it would be irresponsible for us to try to give medical recommendations in this forum.

However, I’ve experienced lots of issues with low blood pressure. I’m in Stage V but am not yet on dialysis so have no personal experience with fistulas. However, with my low blood pressure issues, I tracked my blood pressure throughout the day. I also documented every time it plummeted severely. I put that information into a table. I then sent it to my nephrologist electronically through my patient portal. I also asked a few questions related to the low blood pressure. The last question I asked was whether there was anything we could do to effectively treat my low blood pressure.

So, if I was in your niece’s situation I’d handle it somewhat similarly. I’d get data—doctors like data Then I’d share that data and my questions. It sounds like there are two issues:

1. Fistula access issues related to blood clotting

2. Low blood pressure

So I’d focus on these as I pulled together my questions and my data (for the blood pressure). Then I’d figure out which doctor I need to visit with about these sets of questions; it may be more than one doctor. Also I’d likely ask for the doctor to better help me understand HD dialysis and how it works. Some of what your niece is experiencing may be fairly common for people undergoing HD dialysis ...

Anyway, this is more the type of support that is given through this forum. It may well not be what you’re looking for. I certainly wish you and your niece the best.

Jayhawker

[Bassetmommer NKF Ambassador]

Hi Keyesor,

So sorry your niece is going through all this. We do not diagnose as Mr. Kidney said. I would ask the doctor if the plan is to reinstate a fistula somewhere else? Also I would inquire if there is a reason for the clotting. I say this because I have an inherited condition that makes my blood clot. When I spoke to the nephrologist about my concerns if I need dialysis what will they do for me so I do not have clots. She said others have this issue and they give heparin before dialysis and other things which depends on the patient. So talk with her doctor.

[KidneyCoach NKF Ambassador]

I've never heard of a fistula in a hand. I've seen many near the wrist. Generally women tend to have smaller veins which can cause clotting because the vessels cannot handle the increased blood flow. The vessels respond by narrowing down to slow the blood flow. This can often result in stenosis which then closes off and/or clots off the vessel.

Your daughter did not have a failed graft, rather a failed fistula.

Her hgb also appears to be anemic. The best thing to do is ask her vascular surgeon about a new access.

I'm on my 14th arm access. I've also had 4 dozen or more neck, chest and groin catheters it's not fun.

How long has she been on dialysis? Does she have diabetes? What's the cause of her kidney failure? Blessings

[WYOAnne NKF Ambassador]

On this forum, we can only tell of our own experiences. We are not doctors, nor can we diagnose.

I have had a kidney transplant 20 years ago. When I was on dialysis for a short period of time, they could not make a fistula with my own veins, etc. so I had a AV Graft in my arm that was used. I had problems with it clotting and not being able to use it several times. I too was given a porta-catheter in my chest. There was no problems with this. In fact, they used the port for IV meds and fluids when I had my transplant. I found out from my experience, that it is quite common to have issues with your fistula/graft when receiving hemo-dialysis.

I guess I would trust that the docs know what they are doing. Ask them your questions. You need to be your daughter's advocate. BE HER VOICE - it is her health and LIFE!

Best of luck!

[daxielovinglady]

Is it usual to put the fistula in a hand,?

In the UK, the 1st attempt is opposite the wrist bone, if this fails, the 2nd is mid way between wrist & elbow should that fail the 3rd attempt is inside the elbow.

My 3rd attempt is very strong, everyone gets 'excited' because it's so good.

[Teetee123]

Keyesor was wondering if anyone experienced such. She was not looking for a diagnoses. She was looking for something\anything to help her niece. Relax Mr. Kidney. We are all very aware we are not doctors!!!!!!!