Change in Dialysis Prescription

On Thursday, 11/9/2023 I met with my dialysis team: dialysis nurse, social worker, neurologist, and dietician. It went exactly as my dialysis nurse predicted after my last Adequacy Test; the amount of fluid I am to use now has been increased to 2500 mL from 2000mL previously. This was programmed into the thumb drive that is placed into the Liberty Cycler so it is accomplished more or less automatically.

What isn’t accomplished automatically, is my supply storage and ordering it now completely different. Before I was using one 5L and one 3L bag per session (8L total) and now I can use two 5L bags, two 6L bags (I don’t have any), or many other combinations as long as they add to to a minimum of 10 L.

I was also prescribed Lasix which in generic form is Furosemide. It is used to reduce extra fluid in the body (edema) caused by conditions such as heart failure, liver disease, and kidney disease. This can lessen symptoms such as shortness of breath and swelling in your arms, legs, and abdomen.This drug is also used to treat high blood pressure. Lowering high blood pressure helps prevent strokes, heart attacks, and kidney problems. Furosemide is a “water pill” (diuretic) that causes you to make more urine. This helps your body get rid of extra water and salt. For me, it is being targeted toward making more urine and shortness of breath.

Readers should not come away from this blog thinking that having to change dialysis prescriptions is unique to me. A frequent reader of this blog from Greensboro, NC is experiencing almost exactly the same situations as I have related recently. He is undergoing multiple adequacy tests as adjustments to his fluid amounts and dwell times are being jockeyed in an attempt to ascertain what works best for him. His GP recently recommended a bone density test for him; you may recall that I recently had one and was diagnosed as having osteoporosis, and the vitamins D3 and K2 were indicated.

During my last adequacy test visit, the team social worker had me fill out a Kidney Disease Quality of Life questionnaire. I was provided a summary of this report at this visit which compared me to a large group of Fresenius Medical Care patients who are similar to me, based on gender, age range, and diabetes status. This is an annual requirement on their part. The survey looks at five areas:

1. Physical Health: How well you think you feel physically.
2. Emotional/mental health: How well you think you feel mentally and emotionally.
3. Burden of kidney disease: How much kidney disease interferes with your daily life, causes you frustration, and makes you feel like a burden.
4. Physical symptoms and problems related to CKD: How bothered you feel by day-to-day physical symptoms or problems caused by dialysis?
5. Effects of kidney disease: How your daily life is affected by dialysis in terms of fluid/dietary limits on work or travel, feeling dependent stress, your sex life, or your appearance.

I’ve summarized my results in the table below

As you should ascertain from the foregoing table, I’m hanging in there with the best.