Mum is 80, was diagnosed with lung cancer in Feb this year and then ESRF 3 months ago. She has been having dialysis 3 times a week through a tunnelled line in her chest as she is unable to have fistula and recently has been having problems with hypotension during dialysis which is drastically affecting her quality of life on her non dialysis days. She is only fully recovered from these episodes 24 hours plus later, so ok by the day she is due to have dialysis again and so seems caught in a vicious circle. She does not exceed her fluid allowance of 750 mls per day and in fact some days barely drinks at all other than her Ensure drink (125 mls). She follows a renal diet but has extremely poor appetite and it’s a constant struggle to get her to eat. When she has these episodes of hypotension she becomes really confused and gets extremely frail and is too exhausted to move. She is too weak to stand and the slightest exertion leaves her in such a state it’s frightening to see - it’s like she’s a different person entirely to the way she was at the start of the dialysis session. These episodes occur suddenly without any warning - like a switch has been flicked, and she has to be taken off before the 4 hours are up. She weighs 62.9 pre dialysis and they are drawing off 1000 to 1500 mls per session but weighed 67kg just 4 or 5 weeks ago so has lost weight. She is also having anti coagulant injections to prevent blood clots. Is anybody else experiencing these problems and how have they been resolved?
Low blood pressure during dialysis causing... - Kidney Dialysis
Low blood pressure during dialysis causing problems for my elderly mum - anybody else experiencing this?
I've occasionally had low blood pressure a at the end of my hemodialysis treatments. I'm lucky that I'm back to normal in a few minutes after drinking a little water.
I also have problems eating because since my kidney problems started, food doesn't taste normal. I just have to force myself to eat.
Thank you for your reply. It’s hard for us to understand what mum is going through during these episodes as she gets so confused and afterwards she doesn’t remember what happened so can’t explain. It’s just happened again 90 mins into her dialysis last night. It’s making us all really apprehensive about her treatment. We are really worried about her and what she is going through so to get some insight from someone it has happened to is helpful. Also about the poor appetite. She hasn’t told us things don’t taste the same so we have been struggling to understand why she won’t eat. Mum just says she doesn’t feel like it. Again, it helps to know why this is. I hope you are coping well with your treatment. Thank you again for your reply.
I have had low bp and also blurred visionn esp. during high rate of extraction. Call the nurse they can easily fix it.
Thank you for your reply, I hope you are doing well with your treatment. I am trying to understand why this happens to mum and thought it might have something to do with the HD treatment itself so that’s useful to know about the high rate of extraction. The nurses respond quite quickly to try to rectify it but it’s the thought of this happening each time that worries me as we can see mum gets scared when it happens and she says she doesn’t feel right then gets all confused and can’t speak properly. We can see she is frightened and also frustrated as she can’t get her words out. Does this also happen to you too or have you seen it happen to anyone else?
Low bp caused sweating, increase body temperaure, discomfort and panic situation.
The low blood pressure can be alleviated a number of ways by the dialysis staff: putting her in minimum for a while, laying her further backward, giving her oxygen. I have been on dialysis 2 years and I began having a lot of problems with low blood pressure this year, so they put me on midodrine ( I take it midway through my treatment to raise my blood pressure so I can stand up afterward and even drive myself home). After her treatment. if her blood pressure is really low she should drink at least 8 oz. of fluid (water or gingerale) to give her back some fluid. Oh, and the staff can also give her saline solution during the treatment. It sounds like they may have to readjust her dry weight, too if she is losing weight. Speak to the staff about all this.
Thank you for your reply. I hope you are doing well with your treatment. Since my last post Mum has suffered another episode of low blood pressure and the nursing staff adjusted her treatment. At her last session they started her off slowly and only ended up taking 800mls fluid off but she seemed to tolerate it better. We are uk based so not sure if Midodrine is available here or not but will mention it at her next assessment, also about adjusting her dry weight and the saline solution. Thank you for your suggestions.
I'm so glad your mum is doing better with her treatments! Sometimes you just have to get educated and start speaking up for yourself (or your Mum) in order for the staff to pay closer attention. Good luck and take care!
I have low BP to begin with, so one hour prior to dialysis I take Midodrine a medication to raise my pressure so it doesn't drop any lower during treatment. Maybe her doctor could try something similar. Hopefully this helps, prayers for your mom!!
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