A KidneyBuzz.com regular viewer asked, "How the heck do they determine dry weight? I am constantly feeling wiped-out after treatments and unable to do anything for the entire day. Do the techs have an actual calculator for dry weight? Is there a formula or is it just a case of trial and error? Please help because I cannot go on like this!"
ally Dialysis, patients know - dry weight is a patient's weight without the excess fluid that builds up between Dialysis treatments (your true weight minus any extra fluid). Oddly enough it is, in fact, a bit of a guessing strategy. One patient wrote, "From what I understand it's pretty much just a guessing game; you don't know if you've gone too low until you start having symptoms of low blood pressure, cramping, dizziness, etc." While there are sound professional insights from your Nephrologists, there is no exact formula to calculate dry weight and since your weight typically changes by the day, week, and month - true dry weight is an ever-moving target. However, there are various methods that a Dialysis patient can use to better determine their dry weight and improve health outcomes while limiting the feeling of being wiped out after treatments.
If too little fluid is taken from the body then it can cause cramps, headaches, breathing difficulties, and even heart problems. On the other hand, taking too much fluid from the body can cause a patient to have dry mouth, lightheadedness, cramping, nausea, restlessness, irregular body temperatures, rapid heartbeat, and other heart-related complications. The ultimate goal is to remove just enough fluid that a patient can reach a true dry weight where he/she will be normally hydrated, and does not feel thirsty or uncomfortable. This weight is similar to what a person with normal kidney function would weigh after urinating. Try the following tips to help improve your treatments and better reach your ideal dry weight:
1.) Monitor your pulse and blood pressure. If you notice that your pulse starts to go up toward the end of treatment, then it may indicate that you are close to your dry weight and you may consider talking to your nurse about stopping ultrafiltration.
2.) Use the less than 5% rule. DaVita HealthCare Partners Inc. said, "Fluid gains between dialysis treatments should not be more than 5% of estimated dry weight." Exceeding this 5% rule may cause Chronic Kidney Disease patients to have uncomfortable Dialysis Treatments.
3.) Where is your BNP? There is a blood test called, B-type Natriuretic Peptide (BNP), which can be performed to determine if you are fluid overloaded. This is because Plasma BNP level in the blood is used as a marker of fluid overload. Typically used for Cardiac (Heart) patients, this test can also be prescribed by Nephrologists to determine fluid overload in Dialysis patients.
4.) There's a body mass scale which some Dialysis Clinics have been outfitted with that can measure the approximate percent of fluid in the body. From that, Dialysis Techs and Nurses can get a more precise idea of a patient's true dry weight.
5.) The "Crit-Line"is done through a Hemodialysis machine which measures the "refill rate" of fluid into the bloodstream (perhaps as a percentage of plasma in the blood flow). If your refill rate is over 90% then there's too much fluid, but if it is under 90% then things are too dry (and thus the dry weight needs to be increased). Usually, it's measured over the period of a treatment and helps to avoid complications.
DaVita HealthCare Partners Inc. noted, "Dry weight should be assessed every three to six weeks and adjusted when a patient gains or loses actual weight." Some longtime Chronic Kidney Disease patients have suggested, "In my opinion, it should be up to the patient to figure out his or her own dry weight and not the Nephrologist because they might tell you a number in the clinic and then you may not see them again for another month. How much has your weight increased or decreased by that time?" Regardless, patient insights are critical to determining an accurate dry weight goal. Therefore, you should tell your Healthcare Team if you believe your dry weight has changed or if you are experiencing any discomfort during your Dialysis Treatments.
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How do you best reach your true dry weight and avoid fluid overload as well as feeling wiped out after Dialysis Treatments? Your opinions and insights are important to us and the over 38,000 Friends who have liked KidneyBuzz.com on Facebook. Like KidneyBuzz.com's Facebook Fan Page and leave a comment (click here). Also, visit KidneyBuzz.com daily (1.2 million+ viewers in 12 months) for the latest breaking news, information, Daily Impact Meal, Inspirational Quotes, Products and Services which teach those with Chronic Kidney Disease, Dialysis, Kidney Transplant, Diabetes, and High Blood Pressure how to better manage and improve their lives.