Ultrafiltration getting reduced over time

[Arunachal]

I am on PD since last three and half years. At the time of start of PD, they did a PET test for identifying my peritoneum category viz., high transport, average transport or low transport. Mine was low transport and so I was told that I should use 2.5% strength Solution for PD three times a day manual. All these years the Ultrafiltration was good. I used to get +500 to 600 ml from each 2 litre bag.

Of late, over one month, the UFL reduced to around +100ml from each 2 litre bag. Big swelling in legs was the result. The nephrologist advised to use 7.5% Ico Dextrine as long dwell (12 hours overnight) alongwith 2.5 % two times a day.

This improved my condition. The 7.5% gave an UFL of around +900ML from one 2litre bag and the swelling started to disappear.

I do not know how long the 7.5% performance will last and whether it will also go the way like 2.5%

I would like to hear the experience from others who are using 7.5%

Thanks

[RonZone]

I am VERY much interested in this post. I just started PD last month and am on the cycler using 1.5% solution 4 exchanges per night over 10 hours. I can't do manuals because of back issues. I've often wondered what the "progression" will be for me on PD. Meaning at what point will I need to switch from 1.5% to 2.5% or a mix of the two, then on up.

You are our hero being on PD for 3 1/2 years. That's awesome. I hope mine lasts that long.

I want to follow your journey, as one day it may be my own. i wish I had information to offer you, but you are much farther down the road than I am and I will be looking to YOU for information in the future. I hope others will comment on your post and offer you their knowledge of the progression of PD over time. Kidney disease has "stages". I wonder if PD also has "stages", though I assume where you are at a given point depends on your prescription. And of course the big questions is "how do you know when PD will not work for an individual any longer?" What are the signs and symptoms of that progression other than what you reported in your original post of quick drop in UFL and legs swelling. Did your doctor say this was a temporary issue, or a permanent issue?

So I feel bad to answer your question with more questions, but if you feel up to it. Please document your journey on this post if you have time. I do not remember having a "PET" test as of yet. I need to ask about that. Thank you for explaining about the different transport speeds.

[Arunachal in reply to RonZone]

Doctor did not say it was permanent or temporary. He just wanted to make me better. I told him I am not eating well and I dont feel like eating. He said probably you are depressed after seeing the UFL numbers. If your PET test result says you are in high transport, your PD may work for long long years. I am looking for answer as to What caused my PD (2.5%)to suddenly start failing.

[cahow218 in reply to RonZone]

i have been on PD for 5 yrs and i hope to be able to stay on, until i can transplant. I have become relaxed with it. It allows you have more freedom to do the things you like. I do mine at night , while I sleep. i am also wondering how long does PD work for an individual. I guess every situation is different.

[RonZone in reply to cahow218]

Wow 5 years. You're our hero! That's awesome. I hope I get that kind of mileage. Yeah, can't find anyone (nurse, doc etc) who can give me a good firm how long it will last. So you have raised the bar for us to look up to!

[Arunachal in reply to RonZone]

As long as we do not get infection, I think peritoneum layer should work for long years

[Beachgirl32]

I don’t have any answer to give you I hope someone who has experience this will answer your post. I just started with 2.5 on the machince of two bags when bbl is low I do one 2.5 and 1.5 . I do know the nurse said if swelling like you you go up . I’m glad the 7.5 Is helping you it will be I interesting to hear from other who been on this journey longer to answer you .

[Arunachal in reply to Beachgirl32]

yes. Wish you good health and that you dont get swelling. Since you have just started on PD, you will remain free of swelling for long time

[bumblebee_tuna]

I am in somewhat of a similar situation - have been on dialysis for 1.5 years and am struggling to keep my fluids in-check (edema). My PET test was inconclusive (I did it 3 times) - I am right in between Low and Low-Average. I also just started on icodextrin to try and control the Edema. I only pull around 400ml from the icodextrin so your 900ml is really good!. I pull around 350 from a %2.5 2L bag.

I just had a fistula surgery yesterday as a backup.

Oh - I'm doing an adequacy test today, I'll report back when I get the result.

[Arunachal in reply to bumblebee_tuna]

Good luck to you. I am sure things will improve

[horsie63]

I've only been doing this for a month or two, still manual. I don't have 7.5 only goes up to 4.5 and my neph says don't use that. So I take BP, weight and determine whether to use 1.5 or 2.5 as my clinic directed. Although they look at the amount that comes off that doesn't seem as important. I'll have my first PET on Mar 27 and start cycler training that day so maybe that will be more in line with what you all are experiencing.

[bumblebee_tuna in reply to horsie63]

the 7.5% he referred to is for an icodextrin solution, not the regular dextrose solution.

Just to be more clear - icodextrin has a different formula the % is not comparable to a `7.5% Dextrose solution`.

7.5% Icodextrin (there is only one option) is comparable to something like 3.85% Dextrose in term of UF but it works a little differently (able to pull water off for longer).

[RonZone in reply to bumblebee_tuna]

Really appreciate your explaining that. I didn't want to sound stupid by saying I didn't know they made 7.5% (dextrose).

[Arunachal in reply to RonZone]

I was told ICOdexgtrin is friendly with Peritoneoum layer and does not harm it

[Arunachal in reply to bumblebee_tuna]

Thank you very much for clarifying

[RonZone in reply to horsie63]

How are you doing handling work, dialysis, dogs, life in general? You've got to be worn out.

[horsie63 in reply to RonZone]

These are the longest days ever. Start at 730 and typically get my last exchange done at 9, then there's the dogs, the laundry, taking a shower, vacuuming...it never ends.

How about you and the drain pain? How's Amy behaving?

[RhenDutchess123]

I have been on PD with Cycler for 2 years...( 1700 ml of 2.5% 3 times nightly...total of 5 hours) and have been told that I am a High Transporter..They really don't explain what those UF numbers mean...every once in a while I have noticed that number decrease and my PD Nurse tells me they will change according to how much you still urinate...the more you urinate on your own, the lower the UF number will be...(that you don't need as much water taken off at times)...The thing they want me to watch for is swelling or a dry weight gain..

You say you do manual...my question is how do you know your UF number on Manuel?

[Arunachal in reply to RhenDutchess123]

I use digital Healthsense brand scale which has volume measurement as well.

[bumblebee_tuna in reply to RhenDutchess123]

They give you a scale, let's say you fill in a 2L bag, and after draining the scale shows 2.3L then UF for that exchange would be 300ml. You are suppose to measure each drained bag and record the UF number.

[RhenDutchess123 in reply to bumblebee_tuna]

Oh...thanks for that info

[Arunachal in reply to bumblebee_tuna]

Yes, Thanks for detailed reply to RhenDutchess123

[Tissybell]

Great information, everyone!