exhausted after four weeks of P.D.

[Muesli24]

Is a feeling of exhaustion and low energy typical when beginning P.D.? My husband started it almost four weeks ago and it's working well, but he's discouraged by increasing exhaustion. He'll be seeing his nephrologist next week but maybe someone can share their thoughts in the meantime.

[Darlenia]

My hubby was on hemodialysis for a few months and then switched to peritoneal dialysis. It's very common for anyone on dialysis of any kind to wind up with low iron levels - usually sooner than later. If this is happening to your husband, he may need an iron transfusion or be given a hormone injections to stimulate his body make more red blood cells. (Native kidneys produce the erythropoietin (EPO) hormone which diminishes as they fail.) Another reason for your hubby's low energy and fatigue might be is that the toxins aren't being removed to the extent necessary. You can check that by looking at his kt/v level - it should be at 1.7 or higher. If it's lower than that he likely will need more time on the cycler, etc. Occasionally, a person on peritoneal dialysis may need to switch to hemodialysis if his/her peritoneal membrane simply can't do the work. However, it's rare for that to happen early on. (About 30% may experience failure after five years or so.) It's good that your hubby is sitting down with his nephrologist next week to review his situation and, in particular, his labs. Maybe you can be there with him too for reassurance. It's hard being a caregiver when things aren't going right, we worry so much. So here I am - sending encouragement your way! I think an answer will pop up, adjustments will be made, and your hubby will feel better soon - and you will too.

[Muesli24 in reply to Darlenia]

I really appreciate your taking the time to reply, Darlenia. My hubby actually had an injection of erythropoietin last week due to low hemoglobin (9.4), and thought he should be feeling better due to it. But he looked up side effects yesterday (after I posted here) and found that exhaustion was to be expected initially. Just knowing that made him feel better, since the exhaustion was depressing. His kt/v is 1.82. Thanks again ...

[bumblebee_tuna in reply to Muesli24]

Most likely it's due to Anemia and he should start feeling better now that he got the EPO shot. 1.82 is a little on the low side for someone just starting dialysis, maybe he will need to up the prescription a bit.

[Muesli24 in reply to bumblebee_tuna]

Thanks for replying. Yes, we'll be discussing it with his neph later in the week.

[bumblebee_tuna in reply to Muesli24]

Also, how is his sleep? Lack of sleep can impact daytime energy quite severely.

[Muesli24]

He's been suffering insomnia for a long time, and takes frequent daytime naps. Being retired makes that possible.

[Erifre]

Hi Muesli24, it’s common for some patients to experience exhaustion from time to time. Dialysis is a huge change of lifestyle for everybody around them, specially for us, the ones that experience firsthand the process. There are many ways you can help him going through it. My husband has been on dialysis for almost 4 years and for us, hemoglobin and Phosphorus have been the ultimate goal to achieve. Diet and Epogen injections have been solving the issue, plus, in his case a little extra help from binders (medication for his phosphorus control). This medication (AURYXIA) contains iron, so he receives an extra help.

Regarding the insomnia, it is common for them to feel anxious at first, to process the idea of having this condition, to know that the cycler is your only lifeline is a hard thing to process, but as time goes by, your husband and you will learn to trust and embrace this process. Trust it, pay attention to his labs, and keep your PD nurse and your Nephrologist informed at all times, they will help you a lot. You will learn to provide what he needs to make him feel better. I did it, and it is the most stressful and rewarding experience of my entire life. God provided us with a kidney spare part, and that is exactly our peritoneum. Encourage him to listen some music before going to sleep, keep a healthy diet, or simply ask him about something he has been wanting to do for a long time and do it. We even have been able to travel abroad. We have as every single patient good days and not so good ones, but we stay positive enjoying the good ones. We send you guys our best wishes and will keep you in our thoughts. If you need anything, we all are here to help. This is an extraordinary community full of different experiences, but most importantly, we all are here to help!

[Beachgirl32]

did your husband see his nephrologist yet did he give him any answers . I h

Ave been on pd a year yes I recall I was tired a

Never I haD to get iron . I do not sleep well on pd I get bad headaches at night from it . Thus has been off and on so I know my exhaustion is from lack of sleep . Which I have always had migraines so no fun . I know lots of stuff I read talk about headaches from hemo but not pd but I have found a couple of articles about or and headaches . So hopefully your husband is getting sleep through the night has he had a kt/v test yet that measure the fluid 24 hour urine and blood to see if he is getting the right amount of dialysis . There another test they can do is the pet test that will tell what type of transporter he is and is manual or matchince best for him .