yeah I pass I was worried I wouldn’t last time I barely did with 1.71 but this time I got 1.99 I didn’t have a lot of urine output it seem since I started dialysis it less I think I only did five oz in 24 hours when I first started I had like 14 oz I ask my nurse well where does the urine go she said if I look at my uf numbers they are high my body is getting rid of it that way cause I do drink a lot cause I’m not limit in fluids . They are going to make me do it again in July this one the doctor orde cause I was in the hospital . Everyone at my center get it in July .
kt/v test : yeah I pass I was worried I... - Kidney Dialysis
kt/v test
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Beachgirl32
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Glad you passed...what do they do if you dont ?..up your dose ?
they would have to increase your hours and may have to have more fluid that what they did after I was in hospital in may I went from 7 hours to 9 hour I still use two bags but both are almost empty now where before I had lot of fluid left in one . And they increase the dwell time I told her I never got an hour and half she said you should at least be getting an hour and half I do now sometimes 1:45 dwell . 9 hours is enough for me glad they didn’t have to extend .
how much are you putting in for each "fill" now?
fill 2900 last tidal fill200
Wow, that's a LOT!
so if you do 2900 with two bags, so is that four exchanges per night? That should leave your bags pretty empty by morning.
yes4 exchanges my bag are pretty empty in the morning sometimes I have a little fluid in them
When I fill out my form that they check we just put down intial drain uf and dwell time those are the three thing that come up on the machince when we are done . I had to review my program to see what the fill was .
My team has never asked me about UF or dwell time or any of that stuff that the machine records. Not sure why.
well the diaylis clinic does get the information from share source so maybe that why . My just makes me keep a chart of it to so I can bring it in on doctor clinic day and they can look at that cause doctor clinic days are busy and it hard for them to have to pull up everyone info on the computer they want to make sure we get our questions answers so that why we bring in the sheet.
I think my PD nurse sees about 40 patients. Do you know how many patients yours sees each month? So yeah, I can see how they wouldn't have time to look up everybody's info for each meeting. Though when I go in for my Neph meeting, both the neph and the nurse have their heads buried in their laptops and very rarely look at me 
I actually read an article about that once when I was waiting in my cardiologists waiting room about how docs now spend way more time looking at their electronics than at the actual patient during visits. So yeah, I assume share source provides that info to them, though I doubt they ever look at it unless there's an "issue" that they need to address.
I think it 30 patients. I am blessed with one of the best nephrologist. I get upset when he doesn’t have clinic on some months . But he has two other partners the lady is great but the other guy is like you said his head in the laptop.I only had to see him one time so far. But my doctor and the lady doctor take time and ask me my concerns . Every visit my whole team is in there is yours I have the doctor the pd nurse the dietician and the social worker .
I always bring someone with me incase I forget one of the questions I ask and my doctor will stay in answer everyone of them. So I feel blessed to have a pretty good team.
Ask them questions on know the doctor that I said I don’t like didn’t like it when I ask about certain labs he said well we aren’t so concern with that on dialysis I told him well you may not be but I am and I want to know I ask him about my creatinine and he did look at up and told me but the difference with my regular doctor is he will say no problem Mrs. M I will have that for you in a minute
For sure. all Nephs are not the same. Glad you have a good one most of the time.
Presumably it's the dialysis that's getting rid of the extra fluid rather than your body? That's good news about your KTV score. I would love to be able to see the numbers they use to calculate it as I did a litre of urine yet my last one was apparently 1.3! I am not convinced in my case that this was accurate.
yeah, I'm going to ask how this kt/v calculation is done during my next Neph appt.
Good luck with that! I have never been able to get it.
Yeah, usually when I ask a question like that they just brush it off like I'm too stupid to understand it (which there could be some real truth in that, but that's beside the point, right?)
Yes that is exactly the reaction I get. My clinic have never fine tuned my dialysis prescription. It is exactly the same as the initial one I was given on first day of manual training in Oct 2019. Despite me getting great KTV scores in the first couple of years they just would not modify it nor would they give me and evidence of how they arrived at that decision.
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Kt/v is a standard (outdated) test done monthly for all dialysis patients. It is an adequacy test required by Medicare. The results must be a certain number (can't recall the actual number), if below multiple times they will then usually increase your time. Many people on dialysis no longer make urine. This then becomes the job of the machine. This is why you weigh before and after treatment so they can determine how much fluid should be removed, UF=ultra-filtration. Or for PD patients it's how one chooses green, yellow, red bags as the concentrate is what helps remove excess fluid. Cycler patients will increase dwell time if under the adequacy goal. Hope this makes sense. Blessings
Do you know of a better test than kt/v? You know my team never even mentions the UF numbers that my machine shows me each morning after PD. I'm usually in the 500-700UF range.
I’m usually in the uf 1200-1400 if range
Holy snikes. that's amazing. I'm definitely a slow learner 
Many thanks. I think the magic number is 1.7. Anything lower and they adjust the parameters such as increased dwell or more exchanges as you have explained. My last KTV was 1.3 so they tell me so I am going on to the cycler from doing manuals.
When I first started PD, I thought the percentage of the solution affected how much you "dialyzed". I was surprised to find out that the percentage of the solution, 1.5%, 2.5% etc ONLY affected how much fluid was pulled off your system, that the amount of gunk pulled out of your blood (waste) was determined by the volume of fluid that is put in you and the time it sits there. That was surprising to me. I also failed my last kt/v test, so they upped my volume from 2000 to 2100 this past Monday. I was already at 10 hours. I think they plan to up it again next monday to 2200, then the next Monday to 2300 though at 2100 I'm pretty uncomfortable, so not sure how 2300 will feel. I'm going to see if they will stick with 2200 and extend to 11 hours. That's a lot of time, but I'm willing to do that if that's what it takes for this to work. I just watch tv after hooking up in the evening and dwell while lying in bed watching a show or movie, so it's not like hard work or anything.
?The peritoneal equilibration test (PET) is a semiquantitative assessment of peritoneal membrane transport function in patients on peritoneal dialysis [1,2]. The solute transport rates are assessed by the rates of their equilibration between the peritoneal capillary blood and dialysate
I was suppose to have this one but it got cancel I think Horsie had it you may want to ask about it
Wow, that's a lot of big words Yeah, I never had one of those. Not sure why. So you didn't either. Interesting. Guess they're just doing trial and error method on us
Yes, that's our understanding too - volume of solution, type and strength of solution, and length of time that achieves optimum water/toxin removal. I wondered too about the relationship of urine output and toxin removal; e.g, can the native kidneys, in some circumstances, still produce urine while not removing toxins. I understand that can/does happen. Apparently the underlying reason for the failure plays a role in that. I know my hubby's clearance was slowly slipping but he continued to pee "normally". And yeah, I think nephrologists don't need to rely on kt/v for guidance...they look at lab reports and watch all that data (electrolytes/bun, etc.) - whether each one is moving in good/bad directions - and so on.
Never really understood what "Bun" is.
That makes two of us. All I know is that it has something to do with nitrogen in the blood and all hell breaks lose when BUN (and creatinine) data doesn't look good. They instantly slapped my hubby on dialysis when those two somehow flashed danger signs (or something like that), lol.
All, the Kt/V test measures if you are getting enough dialysis - that is, if you are pulling enough toxins out of your body. It has nothing to do with UF, or how much fluids you are pulling. The official cut-off number is 1.7 or higher. Many centers shoot for a higher than 2.0.
When. you produce less urine, the implication is that your residual kidney function has gone down. That can cause the Kt/V test to fail and you will have to up the does of dialysis - i.e. longer dwell numbers or more solution per dwell.
The PET test is a different test that measures how your peritoneal membrane transports fluids - i.e. High Transports, High-Medium, Low-Medium or Low Transport.
I think the kt/v test is a mixture of urine output and how well your blood is cleaned...along with your Cycler results and the stability of your weight...along with how you feel...after 28 months of PD my kt/v is still 3.16...my Clinic does it ever 3 months....it stresses me out each time tho
that great that your is staying 3.16 I know I was told they test the blood the urine and the dialysis bag
Wow, 3.16. I've got a long way to go to get to that benchmark. You set high standards. You must be an awesome PDer! Say again what your volume is each fill and how long is your total PD for the night in hours?
I do 1700 fills x3 ...about 5 hours
Fingers crossed I get to stay there for awhile....this is a month by month process and can go south quickly....My Anemia is keeping me tired more days than I like these days...I really struggle to eat enough protien..I am at 3.5 and they want me in the 4's..so I keep working at it..but its tough
Hey, I asked Beach girl what her fill is and she said 2900 (see discussion near the top of this thread). I do 2100 now, will be going up to 2200 next monday. So 1700 x3 x 5 hours is great if that's keeping you going.
I started out at 1900 x4 ..about 8 hrs...but after 2 years on Dialysis they decided I was over dialysized...so they lowered the Volume and time ...have been on this new Rx since January and my labs are all good and I feel just as good..so they think this amount of fill and dwell time are plenty for now...it has been nice only needing 1 bag a nite instead of 2...makes traveling easier...I do a kt/v again in July, so will see how I am doing then
Wish I had those numbers! Odd that it would change to required less over time rather than more.
I think they were giving me too much to begin with...My PD Nurse kept telling the Doctor that she thought my Kidneys were functioning better than he diagnosed...and she was right
I think sometimes Nephologists put us in a certain slot and wash their hands....it takes a Nurse that cares about you to think outside the box
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A good explanation of kt/v which is a mathematical equation K multiplied by T and divided by volume. Hope this helps.
omnicalculator.com/health/k....
How do you know what the K and T number is ?
This is from the site KidneyCoach provided. Not that I know what "dialyzer clearance" means. And I don't know if this means time of each dwell, or how long you stay on it each night, and don't know if the V is the volume for each dwell or the total volume for the night:
The abbreviation itself stands for:
K – dialyzer clearance – blood passage
t – duration of dialysis in minutes
V – volume of body water
This value is dimensionless - is not based on any unit and cannot be calculated using its separate parts and their units.
The Kt/ V system, however, may disadvantage women and smaller people and result in worse dialysis results in these groups of patients - this difference is caused by the variances of their body water content.
So a certain amount of dwell time should deliver cleaned blood ..if its cleaner than they are expecting, they credit your own kidney for doing it ?
They did mention to me that my 24 hr Urine had more % of toxins in it than my drain bag sample did...meaning that my own kidneys are still doing more of the "work" than my dialysis does...
That's probably why your volume and time are so low. My natural kidneys are pretty much toast after all this protein I've been throwing at them for the last 6 months.
Naw...the dialysis cleanse out the Protien every night....thats why we have to replenish it every day
Then I guess they just died on their own old beat up selves
Or they are just resting...letting their Buddy Dialysis do the work for awhile...
If you are still peeing...your kidneys aren't dead
For Hemo it's usually available on board the machine itself.
horsie63 Check out what that link from Kidney Coach says about you:
The Kt/ V system, however, may disadvantage women and smaller people and result in worse dialysis results in these groups of patients - this difference is caused by the variances of their body water content.
Since I did it last Friday, I'll find out today. I have a bigger problem though. I was coming back last night around 2 am and somehow collapsed on the floor and couldn't get up and had to call my husband to pick me up. It was both embarrassing and scary. I'll call the clinic at 8 when I know she's there. I've been having balance problem but that was a first.
oh goodness Horsie how your blood pressure I know when my was to low I did pass out.they actually put me on a pill that increase your blood pressure I was on that for a bit. But my blood pressure been ok now not to low. Are you feeling you get enough dialysis. I bet that was scary sorry it happen to you . I hope they figure out the cause. Prayers lifted for you.🙏
When I took it a little bit ago it was 108/80 so not too low. I have been feeling somewhat disoriented and have balance issues.
When your blood pressure gets too low...my Nurses told me to drink a small shot of pickle juice
Dang, that is so not good. Since starting PD my blood pressure slowly started going down from the 140's down to a low of 90's to low 100's. One Sunday afternoon, I stood up off the couch to go do something and the next thing I knew, i was on the floor with a bump on my head where i hit my head on the edge of the couch on the way down. I decided then to take myself off my Cardvedilol blood pressure medicine, which my PD nurse okayed when i spoke with her about what happened. After that, my BP started slowly going back up again and just his last week hit the 140's again, so i started taking 1/2 of a 12.5mg Carvedilol again morning and night instead of a whole pill like I used to take. I have no idea why my blood pressure would be roller coasteering like this. Gonna ask my Neph tomorrow. It's very scary when this happens and you don't know what's going on. Are you totally off your BP meds now? When you say you were "coming back". You mean from work? At your office? In your car?
To bed from the bathroom. I'm wondering when I was in KC doing a cash count , same thing happened. Of course then we were waiting in a hot outer office and I hadn't eaten, plus I had taken the carvedol . Standing agaist the wall and I just slid to the floor. Scared me coworker cause they couldn't wake me. To me to KU Med. This was Mar 2020 before Covid.
They did a full checkout but nothing. this was well before dialysis.
I was doing 2.5 last night, I wonder if it was taking too much. And I haven't been able to eat much lately.
they made me stop the carvedol I haven’t taken it since may bp a lot better
I'm going back on half dose for now, just to see what it does. Funny how mine came down then started going back up again. .
Ahh, ok, from bathroom to bed. Oddly enough, I don't have to go to the bathroom at night any longer since I started PD, so that's a little perk for me anyway. So this was occurring before PD. Interesting. Could it be low blood sugar levels? I had an uncle who kept a pack of peanut butter crackers in his pocket all the time for occasions when he would feel "swimmie headed", as he called it. So combination of taking too much fluid off and not keeping blood sugar level up might be a contributor for sure.
How are you handling work with dialysis, so far so good?
So far so good but I have a couple of issues I need addressed. My PCP is out this week and next we're supposed to go to Wichita for an audit
Hey, REALLY glad to hear you've been able to get work/dialysis/home-animals stuff worked out for the most part. I know it's not been easy for you, but you're a trooper. Do let me know how Wichita goes. You got this.
Questions I have for my NEPH about this:
Our standard Kt/ V calculator uses the following equation:
Kt/V = -ln((Post BUN/Pre BUN)- 0.03) + (4 - 3.5 × (Post BUN/Pre BUN)) × (UF/Weight)
Where:
Post BUN means the level of post-dialysis Blood Urea Nitrogen, given in milligrams per deciliter (mg/dL).
Pre BUN means the level of pre-dialysis Blood Urea Nitrogen, given in milligrams per deciliter (mg/dL).
UF stands for the volume of removed ultrafiltrate, given in liters (L).
Weight stands for the post-dialysis weight of a subject, given in kilograms (kg).
ln stands for the logarithm with the base of 2 → the natural logarithm.
--------My questions:
I always weigh myself BEFORE dialysis as I was told to do, will that affect this outcome?
From what source is "Post Bun" derived, the blood taken when I bring in the urine and effluent specimens?
From what source is "Pre Bun" derived?
Do you get my UF from the information sent electronically by my cycler?
It's very similar to a 24h urine collection. You will collect all the fluid from the cycler and any manual exchanges you make plus all the urine that you make. You then have a choice - you can sample the fluids and bring the samples or bring it all to the clinic and let them do it (I usually just bring everything over because I don't like needles). They also take a blood draw.
KidneyCoachNKF Ambassador
I can't recall the PD protocols but for hemo, blood draws before and after treatment. Weighing before and after treatment, liters of blood processed, total volume of fluid removed. Blessings
I passed with a 1.9 barely squeezing by but I'll take it. I have the repositioning surgery on the 17th so hope that helps. Had the killer drain pain again last night and I'm so over that.
Working on a couple of referrals...one for the itchy bumps all over that the steriod cream did nothing for and then one for this awful balance problem. I'm hoping it's inner ear and easy fix the other is a possible neurological problem. At this point I'm tired of doctors.
well you past that what count they didn’t make me take the kt/v again for this month of July where they were having all her pd patients take it since my mom as just in June order by doc . So you said repositioning are you going to have the catheter repositioned? I hope they figure out your balance problems. My case goes to the transplant committee today to see if I can get back active . Will find out tomorrow. The hey said I stay in my place. The neuro clear me for transplant we are. Watching the aneurysm .
Yes reposition the catheter and I really hope that fixes the pain when I poop and the god awful drain pain.
Didn't have any of these issues until I started dialysis. Sometimes in the midst of the worse drain pain I wonder if it's even all worth it. I wanted PD so I could visit my granddaughter but where they live it would be impossible to do. I can work but I have all these appts and they disrupt things. I itch all over and before you ask, yes my phos is within normal. I now have this balance issue where it's difficult walking. I can't concentrate. I forget things all the time. I'm only 59 so I doubt it's Alzheimer's. It's exhausting.
Rant over.
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