been on the Amia a few years now. Usually use 1.5 and a 2.5 solutions together with the last bag being 2000ml of Icodextrin, so 3 bags total. With this combo I do PD as I sleep. Machine doesn't usually beep until I'm nearing the end. I can deal with that. My problem is when I use two 1.5 bags drainage is poor. Cannot do PD while sleeping when using two 1.5 bags as the machine beeps quite a bit. I usually input 1900ml every cycle. When draining a yellow bag it almost always leaves 400ml or so inside me before it starts to refill me with the next 1900ml. I prefer no more than 2000ml in my belly. As the cycles progress what it leaves in me seems to increase. My last fill of Icodextrin is supposed to be 1800. I could only take in 1000 of the 1800 because I had 855ml left over from the drain of the 1.5 solution. Standing does practically nothing to decrease the 855ml. Using two 1.5 bags is therefore difficult. The poor/incomplete drainage is a problem. Baxter said to speak to my kidney doctor about it. Any suggestions? Thank You in advance
Issue when using 1.5 solution on Amia - Kidney Dialysis
Issue when using 1.5 solution on Amia
I have the Claria and only use 2 bags…always the same type so that’s certainly an interesting problem. I’d definitely like to here the resolution.
You and I definitely need to compare notes. I'm having similar issues, but I've not got the specifics to back it up. I just thought it was me. So for the next few nights, I'm gonna record my numbers and post them here for you to see how they compare to yours.
I'm also on the Amia. I use 2000ml each of 4 exchanges for the night over 10 hours. I use two 6000ml bags of 1.5% solution. At my last test my kt/v was 1.7. My nurse said that doesn't seem right so she's going to do another test next month to check. I look forward to having some information to go in to talk with her about concerning the issue you and I are having.
At the end of my treatment in the morning, the machine says I need to do additional drain. (I do not carry fluid during the day, so it all needs to come out when I get up in the morning). I let it do that additional drain, sometimes it says I still have over 400ml left to drain. Then once that drain finishes. I choose "Treatment Options" and do a second drain using the button to do that with under those options. This normally reduces my fluid volume anywhere from 50 to 120ml more. But even then, sometimes it will stop draining and sound an alarm of "slow patient flow" before it completely finishes the drain according to what it says is the amount of fluid remaining in me. I know that may sound confusing. I'll get exact terminology in the next few nights as I record things.
But it sounds like we have similar issues. I get alarms all the time with my "Amy".
hi RonZone. I called to try to get some assistance on the phone but they weren't able to answer my question. I was told that my kidney doctor needs to call tech support. I can use two 1.5 bags but it's a lot more work. I have to keep an eye on the machine. My Amia is setup to fill me with 1900ml except for the last fill which is 1800ml. Out of that it drains maybe 1500. It never drains completely. I do 6 cycles total. Usually for some odd reason the last two cycles are the worst for draining. I took a photo to show one of the kidney technicians so she could see what I was talking about. When the last fill started I still had 855ml in my belly. This is why I can only do the two 1.5 bags while I'm awake. I do walk around with 1800ml of solution in my belly during the day. Eventually I will coordinate with my kidney doctor and see if we can figure out what's going on. Until then I will stick mostly with one 1.5 and one 2.5.
oh just to confirm, when you say 1.5 you are taking about the solution percent like 1.5% and 2.5%, correct? Not the size of the bag (mine are 6000ml bags of 1.5% solution)
Ok, I checked my numbers for last night and this is what I'm getting for my four exchanges:
1st Exchange - 2000 in, 1730 out (-269UTF)
2nd Exchange - 2000 in, 2097 out (96 UTF)
3rd Exchange - 2000 in, 2157 out (157 UTF)
4th Exchange - 2000 in, 2516 out including the "extended drain" it asks me to do at the end (515 UTF)
Then it gives me the option in the Treatment options for doing a "Post Therapy Drain" when drained 52ml more but then left 10ml in. This Post Therapy Drain changes in amount from night to night. It was pretty efficient last night.
So you're doing 6 exchanges including the one that leaves 2000 in during the day, correct? For how many hours from connection time until the last drain and fill? 855 is a lot of fluid to still be in there. Do you have the option under Treatment options to do the "Post Therapy Drain"? so you can get rid of that extra fluid before filling with 2000 for the day. That's a temp fix for this until you can find out what's going on with your program settings with your PD nurse or Neph.
Yeah, it's a pain that we can't deal directly with tech support ourselves. I have no control over the program at all. Have to go through the PD nurse for any program changes or tech support. Guess they don't want folks messing with their own "prescription", but it sure is a pain to have to do that.
When is your next Neph appt so you can talk with him about this. Does your PD nurse have any ideas on why this is happening? Did it just start happening or has it been doing this for a while. These are machines made of hardware and software, so things do go wrong with them. My first "Amy" only lasted a week before I got the equivalent to the windows blue screen of death and they had to send me a new cycler.
so it is 6 cycles for 8 hours total for the treatment. The dwelling time is about an hour. All the fills are 1900ml except for the last which is 1800ml. 1800ml is what I keep in my belly until the next treatment. 1800ml of Icodextrin which is the last bag. For now I am back to using one 1.5% and a 2.5% along with the bag of 2000ml Icodextrin. I told my doctor that next time I see her she needs to call tech support. I see her just once a month.
Under Treatment Options the options vary. Sometimes I have the option to stop the fill phase and the option to drain extra fluid. Also the option to end treatment. The options seem to vary at times, depending on where I'm at in my treatment. I've had my Amia for a while now, maybe 2 years and it appears to be working fine. Seems to be consistent. The 1.5% bags have always drained poorly and I may have mentioned it to my doctor before. It's only now where I am making it more of an issue. Hopefully I'll see my doctor in another 2 weeks so we can get some answers.
I routinely get "Slow Patient Flow" alarms with my 1.5% drains as well. I never once thought it could be the percentage of the fluid that might be responsible for them. I chalked them up to the placement of my catheter and sometimes constipation. Those are the two causes my PD nurse told me about. My alarms reduced frequency for a couple weeks, but then started up again. So it's been very difficult to tell what exactly is causing them. I do know that I get fewer when I sleep on my left side it seems, thus the thinking about catheter placement, but it's never consistent. The same with when I feel like I'm constipated or not. Get alarms sometimes, sometimes not. So this is new information that it might be related to the fluid percentage. Please do share what your doc says after you ask. I'll bring it up with my PD nurse and my Neph as well.
I've only been using Amy since mid January, so I don't have a very long trial history as you do. I hope to learn a lot between now and when I've been on it as long as you.
And yeah, I have the same Treatment options it seems. I just never use any of them mid treatment, so am less familiar with those than the one a the end of treatment. Interesting that they have you doing 6 1-hourish cycles. I wonder if that would give a better kt/v than my 4exchanges over 10 hours? Mmmm.....
I think the slow flow has to do with the 1.5% solution. When I start my treatment I put the 2.5% solution first and the draining is very good for the first 4 cycles. When I get to the 1.5% is when things start to slow down. My bowels can be clean but it doesn't seem to matter when I use two 1.5% bags. It is very frustrating.
I'm going to be very interested in what your doc and tech support says. And what mine says about this.
We are too, RZ.
HEADLINE: The machine frustrations continue!
My husband is having surgery Tuesday to either reposition or replace the current catheter. This is because of the persistence of alarms on the Baxter Amia cycler at just about at the 2/3 mark for every cycle. Not great for sleep, the last thing he needs when both on dialysis and working full-time! As someone else has noted here, the cycler alarms seem to come on more frequently and with less of the drain complete when both bags are 1.5%.
We haven't found the happy medium between water removal and low blood pressure. Currently, he's supposed to be on 5 cycles of 2500 mL each, using 1.5% solution, because his blood pressure has been running low. But not enough water is removed on the 1.5%, so we've been periodically using one 2.5% and one 1.5% 6000 mL bag. He's also on BP meds which we're now okayed to reduce if his top BP number is <115.
At the end of the night, the cycler puts in 2000 mL of extraneal for the day, which he manually drains and replaces with another 2000 mL of extraneal when he comes home from work. That last bit is drained at the beginning of the overnight PD.
I feel for your husbands situation I TOTALLY understand the frustration of the alarms and working. Some days I do ok, others, I feel like a zombie. My BP has been fluctuating between 100 and 120 for the top number. It's never consistent from one day to the next and I get a bit dizzy when standing up sometimes. I'm currently taking cardvederol for BP, but my doc said they might need to change that and try something different when i go in for my monthly meeting with the Neph.
I've been using 1.5% solution continuously until they do another 48hr urine test next month to reassess how I'm doing.
I guess they call this a "treatment" because that's what it is. It's not natural what we're doing, and our body is saying "what the hell is going on here" and trying to adjust as best it can. We're basically trying to replace thousands if years old natural processes with mechanical witchcraft.
I have an appointment next week with my doctor and I will try to get some answers. I took some photos of the cycler so they can see how much 1.5 solution is not getting drained. I guess my main question is why I cannot have a full drain when I use two 1.5 bags and still have a low UF. I find it hard to believe that I can only have a low UF if 500-600ml stays in my belly on every cycle's drain. Very frustrating as you know. For the time being I will use only a 2.5 and a 1.5. If my blood pressure gets too low I'll drink some water with salt in it to get it back up.
oh, Ok I'm just seeing this where you say you drink water with salt. I'm gonna try that. What did your doc say about the solution not getting drained using 1.5 solution. I've not seen my neph yet. Will see him next tuesday.
I was told it's pretty much the nature of the 1.5 solution to drain as poorly as it does. I'm afraid there's not much I can do about it. Luckily I use mostly a 2.5 and 1.5, rarely two 1.5 bags. I've attached an image file for illustration. That is the point where the last fill is just starting. As you can see I still have 855ml of 1.5 solution in my belly. My last fill is supposed to be 1800ml. If I took in 1800 with 855 still in my belly that would make it 2655ml. Not good. Too much for me. So I take in just about 1000ml to make it 1800. The last fill is Icodextrin so about 800ml of Icodextrin goes to waste. Not much I can do. I showed this to my doctor so she could get a good understanding of what happens.
As I understand it, PD is better than hemodialysis because it better mimics the kidneys and is done on a more-or-less continuous basis. Without the alarms every 1.5 hours, that *might* be so.
Hi RonZone,
How do you get the four night exchange in and out numbers? Do you know how to adjust the hours and the minutes of the clock that appears at the top right-hand corner of each screen when going through the operation step by step? I'm asking on behalf of my girl friend who is on Amia cycler just less than a week. Her program is 4 cycles, 2000 mL each for 8 hours with a combination of 2.5% and 1.5%, and 1500 mL of 7.5% for day dwelling. English is not our native language and she is too shy to ask anything about her health matters. At the start, she has already the same problems like draining and alarm issues like everybody else. I'm just trying to help her out and appreciate your advice. Thanks!
Hi, Not sure what you mean by "in and out numbers". Each exchange is set for a certain amount to be put into the peritoneal cavity. Mine is 2000ml. When you see the "treatment complete" screen in the morning, there's a button that says "view details". This will show you each "dwell" and how much was drained after each one if that's what you're asking. I don't do a daytime dwell, so it might be different for you, not sure. Yes, she will have the issues with drain pain and alarms for the first couple of months, but it will slowly dissipate as her body get's used to all of this. At least mine did. Though I found that i still can't drain while on my back or I get drain pain and alarms every time. So she will need to do some trial and error to see which position, right, left, or stomach works best to reduce drain pain and alarms. As for setting the clock after my treatment is complete, I tried to go into the Menu, then Preferences on the Treatment Complete screen, but found the date and time are grayed out so I cannot adjust. You might have to get the PD nurse to do that for you. I'll see if I can remember to check again tonight when first starting and see if I can adjust it then.
I'm excited getting notice of your reply, not knowing this HealthUnlocked system is doing so well. Yes, the "in and out numbers" is the fill and drain volumes of each exchange. Many thanks for letting me know the easy and magic way of pressing the "view details" button to get the information I'm looking for! My girl friend did use different positions trying to resolve the alarm and drain problems, sometimes work sometimes don't. Did you find "marching" work for you? When the lady (I forgot her name) first suggested this exercise "marching", you said interesting and would like to try it. To your understanding, does "marching" for the draining help means station in one spot raising each leg one at a time without walking? The clock never displays the correct time and it's nice to fix it if possible. Next time when seeing the PD nurse we'll mention that.
Hey, you and your girlfriend will find much helpful information and people on this site. She really needs to get on here and get to know some of these people as well as you. She would enjoy it if she did. Let me know if she feels like taking that adventure one day. This also has a private message system where you can click on someones "icon" or name and go to their "page" and click "message" to send a private message to them. So she can use that feature as well to connect with people if some things she doesn't want to discuss with everybody in a post.
As for the "marching". In the beginning, when I was having a lot of pain drain and alarms, I tried just about everything, marching, rolling, jumping up and down, standing on my head
What happens is that some of the fluid get's "stuck" in crevices and the little tube can't pick up enough fluid, meaning the flow of the fluid is not the amount the machine is set to require, so it throws the "slow flow" alarm. That's the one I got most. I finally just started getting out of bed and standing next to the machine and sorta jumping up and down just a little, or yeah, doing the march thing, made the fluid settle into where the tube could pick it up and that seemed to make it happy, then I would go back to bed. I tried just rolling into different positions but that never worked lying down in the beginning. I have NO idea why, but as time goes on, the tube settles into a spot where it can pick up enough fluid not to sound the alarm. Maybe it takes time for it to "shift" into whatever position that is that it likes, but after a couple months it started settling down, now I get a random slow flow alarm once, maybe twice a week, but that's usually when i wake up and I'm on my back, which it definitely doesn't like. So I hate to tell you that you're going to have to live with the alarms for a while, but yeah, you're going to have to live with the alarms for a while, like folks with a newborn baby getting up to feed it every two hours for the first couple of months.
Yeah, see if your PD nurse can adjust your clock. Mine is still set on daylight savings time, but I just let it go since the time will change again in a month or so. I figure one hour won't make any difference. But yeah, they should have that so the user can change it and not have to go through the PD nurse every time the time changes. You can actually call Baxter Support 800-284-4060 and see if they can change yours so you can set the time yourself.
I think everyone is a little bit different. I am on the Amia machine and have varying results from using 2.5 and 1.5. I keep getting negative numbers and so have to go to two 2.5 bags every other night or so. The problem is that decreases the blood pressure. So, it is a tricky balance. Last night, for example, the number was -162 which is not terrible, but my blood pressure is down as well. So, tonight I will use two 2.5 bags and no doubt the number will be positive again. I don't think there is any way I can consistently use a certain combination of bags, but will have to keep varying them day by day to keep things sort of in balance. I am fortunate that I have a very good PD team and can call them anytime to check to see if I am on the right track. So far, I have been. I have only been on this thing about a month or so, so it is a learning curve.
I had a problem with the first catheter that was put in. It was a a straight one and would not drain at all. That was removed and they replaced it with a coil. That seems to be working better. Also the bowel routine is very important in my case. If I am overful, I cannot eat much at all and so little or no bowel movement. You have to eat to poop, apparently, so that is also an issue. I find if I take a senokot at night and a small (15 ml) of lactulose in the morning, things seem to go along better. I am also able to eat and am trying to pay more attention to things like fibre in my diet.
The best thing you can do, in my opinion, is to keep careful track of the numbers, and discuss it with your PD team. I use three bags...two 5000 and one 1500 extraneal if that makes any difference. I think the Amia machine is a bit different from the Claria, but I don't know anything about that. I also do this at night, I get no alarms and generally sleep through the whole thing.
I do a temporary disconnect every night around 4 am as I have to let the dog out and give him a snack so he will stay in bed until the machine shuts off around 8 am. This takes about 10 minutes and I have timed my alarm to a dwell cycle
I use the prescription of one 1.5% and one 2.5% pretty regularly. The problem is that I tend to have a lower blood pressure sometimes so my doctor wanted me to use two 1.5% bags every now and then which lowers the total UF and helps with blood pressure. I pretty much never use two 2.5% bags. And yes, it is all a balancing act.
Hey, all of a sudden I'm having low blood pressure issues. actually passed out when i went from lying on the couch to standing up yesterday. That was freaky to wake up on the floor. What do you do to help keep your blood pressure up? More fluids, more salty food?
I have fainted all my life. It seems more frequent now. I was at the garden Centre today…..hot and humid. I passed out at the check out counter and got to lay on the floor for awhile. They have to call EMS, who came and checked me out and home I came. Low blood pressure, heat and too much walking around. Sit down or lay down before you fall down is about all you can do. I have one of those medical alert devices to wear as well. In case I am home alone. I find head down working in the garden will do it too. I just lay there for awhile. Today, my daughter was with me, so that was good.
I have fainted from time to time since I was a child. So I learned early not to stand up or get out of bed too fast. I don’t know what else I can tell you except to avoid things like hands above the head too long, standing in line for long periods especially in heat. I am certainly a lot worse since kidney failure. Or maybe it’s old age.
Hey, this was my first time every to pass out like that in all my 70 years. Very interesting event. I can't imaging having that experience a lot like you have. Wow.
it’s a vagus response. I’ve learned to manage it and was stupid yesterday. I knew I should go sit down for a bit, but decided I could make it through the check out and to the car. Sometimes I get sweaty and feel clammy and go lay down for half an hour. It’s got worse with the low blood pressure occasionally, an over zealous helper takes me to the hospital and they run all kinds of tests and send me home in a couple of hours. Just sit down or lay down before you fall down and hurt yourself.
I also have one of those fall devices that calls for help. My daughter insisted I get it. It’s not a bad idea if you are going to continue to faint. You can hurt yourself falling on things and might break a bone too. I didn’t worry about it when I was younger, but it pays to be careful
Hey, all of a sudden I'm having low blood pressure issues. actually passed out when i went from lying on the couch to standing up yesterday. That was freaky to wake up on the floor. What do you do to help keep your blood pressure up? More fluids, more salty food?
I tend to suffer from low pressure rather than high. By low I mean between 90-115. I don't hit the 90 mark that often but when I do I drink salt water. I fill a glass about halfway with water and then add salt until it is salty enough. I sip that and it gets the pressure up in about 30 minutes or so. I've gotten that lightheaded feeling when it's low but thank God I haven't passed out.
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