Renal Replacement Therapy

[Guest]

Hi,

First of all I would like to thank you in advance as I know you must be very buzy. My husband has now been on dialysis for about 2 mos. He seems to be feeling worse instead of better. We have had people tell us that he should feel normal after dialysis and some to tell us that he should feel better. He is really tired of course after dialysis and then the next day he is weak and very tired. On the second day he feels really well when he wakes up and in the afternoon it is time for treatment again. All of the pamphlets I have read says you can have a good quality of life on dialysis, but so far no good. My husband is 54 yrs old and has a great attitude, but he seems to be going downhill. What do you think could possibly be wrong?? Could they possibly be pulling too much fluid off?? How do you find out what your dry weight should be?? Thanks so much for your time.

Sincerely
Debby Hogan

[Guest]

It is impossible to predict how a patinet will feel once started on HD. Many patients feel washed out on their HD days and feel better on the days after HD. I usually tell patients there is a period of adjustment to the HD routine and usually after 4 to 6 weeks of HD there will often no be any futher improvement in their symptoms.
The Nephrolologist needs to manage the overall care and make adjustments in the HD perscription. This includes adjustiong the "DRY WEIGHT". This often fluctuates over time and needs to be contiunually adjusted.
There is a new trend in HD that is looking at Nocturnal HD or Daily HD These modalities perhaps are better tolerated. Only a very few places in the country are offering this type of treatment.
Alternatively one can go on PD (Peritoneal Dialysis) which is better tolerated by some patients then HD. Lastly kidney transplant in 54 year old would most likely be the preffered treatment so long as there are no medical reasons why he can not undergo kidney transplantation.
[quote] Hi,

First of all I would like to thank you in advance as I know you must be very buzy. My husband has now been on dialysis for about 2 mos... [/quote]