dialysis’ : I am on In center HD for about... - Kidney Dialysis

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htpi1543 profile image
14 Replies

I am on In center HD for about 6 weeks and I hate it. They say that HD removed toxins from the blood. Can someone tell what toxins it removes from the blood? I know it removes potassium and phosphorus and sugar. What other ingredients? I will highly appreciate the info.

Thanks

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htpi1543
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14 Replies
Bassetmommer profile image
Bassetmommer

Hi,

Our bodies constantly manufacture waste products. Think of your body as a machine. Food is the fuel and when consumed and processed it becomes energy. All energy gives off a byproduct. ALL! So, when the blood passes through the kidneys, they are the filters that remove spent energy and fuel. This is waste which we pass as urine and feces. If not able to be filtered and passed, we become toxic in our own waste products. This is why when the kidneys fail, you feel terrible. Think of a junked-up car engine with old oil that is all gunky and dirty. This is what happens (in a manner) with our blood. I hope this really liberal explanation helps.

htpi1543 profile image
htpi1543 in reply to Bassetmommer

thank you for the explanation. I thought that dialysis will clean creatinine but it is pretty much the same as before dialysis. That’s what confuses me.

Darlenia profile image
Darlenia in reply to htpi1543

Dialysis does lower creatinine and the lower value can be seen immediately following a session. But then it immediately builds back up in your blood until your next dialysis session. If insufficient creatinine is being removed, your nephrologist will likely make adjustments to your dialysis protocols. Sometimes dialysis can remove too much of something, other times it may not remove enough of another. For example, hemodialysis generally doesn't remove enough potassium so most people are put on binders for that. Your lab reports will be reviewed on an ongoing basis so things will stay on track. Hope this explains the situation somewhat for you.

htpi1543 profile image
htpi1543 in reply to Darlenia

Thank you Darlenia for explaining very clearly.

KidneyCoach profile image
KidneyCoachNKF Ambassador in reply to Darlenia

Dialysis does remove potassium but only small amounts of phosphorus which is often requires binders. A couple of years ago a new med (binder) for high potassium was released. It is the first potassium binder (Valtessa) ever for dialysis patients, not many will need this med.

Blessings

Darlenia profile image
Darlenia in reply to KidneyCoach

You make some good points. Hyperkalemia is known to increase for some on HD; apparently some underlying causes for the kidney failure, particularly diabetes, help set that off. So my hubby, a diabetic, was forced onto potassium binders rather early on when he was on HD. Then, when he moved to PD, he required phosphorus binders, and the potassium binders were dropped. (Apparently HD removes approximately 900 mg of phosphorus per treatment whereas PD removes approximately 300 mg each day.) We were grateful binders were available in both cases - although my hubby was quick to note that he much preferred the potassium binders (probably the one you mentioned) over the tarry phosphorus binders. Lol.

RonZone profile image
RonZone in reply to Darlenia

My neph just started me on phosphorus binders, but it's a pill version called "Calcium Ace". What kind did your husband use that were "tarry"? Just curious. And this was good info to find out there's also a phosphorus binder. Is there a sodium binder? If so, I could eat pretty much whatever I want and then take a handful of binders, right? (I know that's not a good idea, but it sure sounds yummy!)

Ziggydoodah profile image
Ziggydoodah

Just to say i am on Haemodialysis too. Been on it just over 3 months. I know it is keeping me alive but right now, im hating it too. I just seem to go to work or dialysis. I have 2 mornings off but usually have to schedule any hospitalnappointments then. Just wanted you to know, you arent the only one!! Take care.

KidneyCoach profile image
KidneyCoachNKF Ambassador

I know if potassium is too high they can lower the potassium dialysis bath even to zero to help lowering serum potassium. Very often patients will also be prescribed kayexalate which removes extra potassium through the largest transporter (removal) in body -- the large intestine. Kayexalate is nasty stuff which causes diarrhea and removal of potassium, tarry stuff.

Phosphorus is a middle molecule but acts like a large one. Therefore very little is removed during standard in center hemodialysis. Longer, slower hemodialysis can and does remove phosphorus with more, longer contact with dialysate, time--like 20-24+ hrs per week. I run about 24 to 40 hrs per week.

The potassium binder called Valtessa was only released for dialysis patients 2-3years ago, never prior to then.

Phosphorus binders (renagel, renvela, phoslo) have been around for about 30+ years and as a general rule dont cause diarrhea. I could be wrong just my near 21 years on dialysis, short stint on PD and research since diagnosis in 1982. Sorry if im wrong. BLESSINGS

Darlenia profile image
Darlenia in reply to KidneyCoach

It seems like the binders have come a long way. Speaking only for my hubby, he really disliked his phosphorus binder since it had iron which made him gag and then go "ugh" with the outcome. Lol. There is choice, though, as long as one's insurance coverage approves. Thank you for the run down on the progression of binders which proves that. As an aside, wish they would also come up with a binder for sugar! So many areas that need work - your 21 years on dialysis speaks to that. Hang in there, KidneyCoach!

RonZone profile image
RonZone in reply to Darlenia

I would be all over a binder for sugar! :-)

Tissybell profile image
Tissybell in reply to RonZone

You and me both, Ronzone. It's great to hear that you resolved the back pain issue, and are doing well on overnight PD. I am looking into the purple dialysate to control blood sugar. This solution has to dwell in your abdomen all day. I really like the Baxter Amia, though. I rarely hear alarms, even when I wrap the tube around myself twice. My prescription doubled, and since then I quickly gained 20lbs.!

Tissybell profile image
Tissybell

I had to spend 4 months on center hemo. The main complaint is the time and travel costs. It was pretty boring most of the time since my sleep apnea kept me from being able to nap. I felt better than when I was on PD, though, which I have resumed. I found it really challenging to schedule appts around center hemo, or any other things, for that matter, like visiting family.

Tissybell profile image
Tissybell

One thing I forgot to add was that hemo made me hungry, and I just could not get enough food! In spite of that, I never gained weight. I wonder if hemo removed more protein

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