Taking off and tanking

JD writing: Review: Kate is thin...BMI is about 19...if it's below 18.5 she's in danger of being taken off the transplant list... Kate has normally low blood pressure, 90/60. Kate--unlike most every other patient at her dialysis center--has kidneys which produce almost normal amounts of urine.

This last week, on both Mon and Wed, more that 2L of fluid was "taken off" her circulatory system by the Fresenius dialysis machine: with a screen image of the machine shown below

In the image above the lower left "2650" represents that the machine has drawn off 2.65 liters at this point, with 56 minutes left in the treatment. This "patient" has BP of 100/70...

At any rate, in Kate's case, with about 20 minutes left in her sessions, she began to have her vision close in and her her hearing diminish, without losing consciousness, before the tech switched to adding saline to the line going into her fistula on her left arm. Her BP dropped to about 70/40. A stressful time for her.

You can appreciate that for a typical patient on dialysis the goal is to remove as much urea-laced fluid as possible. But the typical patient likely has high blood pressure (the leading cause of end-stage renal failure) and has not passed any urine since the last treatment.

In Kate's case, with low BP, and passing urine (albeit w/o much urea with it), it could be prudent to stop the fluid removal at some level less that 2L. So think I, her husband.

On both days Kate regrouped and drove us both back to home, stick shift and all, in the M6.