Dialysis and Lasix

[calmone]

I just have to ask this question. I think (hope) I know the answer but after asking around at work am not sure. Here goes.

I work LTC. I have an 85 year old female resident that has hemodialysis 3x week. She does not urinate. She is on Lasix, 30mg BID R/T CHF. In a person with normally functioning kidneys the fluid is excreted through urination, weeping etc. Well, this resident does not urinate and there is no weeping or any excess loss of fluid that I can see. So, my question is- Does the fluid come off in dialysis just like the other toxins that come off that accumulate from not urinating? She does not have any edema or other signs of fluid accumulation/loss. What happens to the fluid pulled off from the lasix in a dialysis patient?

Thank you for any help.

Linda

[nurseprnRN, BSN, RN]

"seems you have a wee puzzle on your hands ;)" ::groaning::

i was also troubled by the (paraphrasing here) "lasix pulling off fluid but if there's no urine does it go out with dialysis" line of reasoning.

i must assume that the op is not a nurse, because any nurse would (or damn well ought to) know that the mechanism of action of furosemide (lasix) occurs in the kidneys; any water "pulled off" is excreted by them in the form of more dilute urine.

also, hemodialysis and peritoneal dialysis remove fluid from the blood by osmosis; furosemide would have zero effect on this or the fluid the dialysate "sees" across the membrane (either in the hemodialysis "kidney" or the peritoneum).

i'm with the folks who say that if this lady is truly anuric, she is only getting furosemide because her caregivers didn't know enough to how it worked, didn't know it won't work on her anymore, and/or didn't care enough to bring it to the attention of the physician to get it discontinued. harsh? you betcha:down::down:.

[agldragonRN]

i just have to ask this question. i think (hope) i know the answer but after asking around at work am not sure. here goes.

i work ltc. i have an 85 year old female resident that has hemodialysis 3x week. she does not urinate. she is on lasix, 30mg bid r/t chf. in a person with normally functioning kidneys the fluid is excreted through urination, weeping etc. well, this resident does not urinate and there is no weeping or any excess loss of fluid that i can see. so, my question is- does the fluid come off in dialysis just like the other toxins that come off that accumulate from not urinating? she does not have any edema or other signs of fluid accumulation/loss. what happens to the fluid pulled off from the lasix in a dialysis patient?

thank you for any help.

linda

after 5 years, i hope the lasix was d/c'd already by this time.