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Discussion

Dialysis and headaches

I have a patient that c/o headaches about half way into his treatment. He comes in fluid overloaded and has

+3 BLE edema, no SOB and his lungs sound clear. I usually have to take off 3 - 4kg of fluid per treatment to reach his EDW. He does have a UF profile 60%, his tx is 3 hours long.

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    Thats pretty quick to get 3-4 kgs off - I would discuss with the doc/mid-level about extending his treatment.

    The latest research shows that a 12-13ml/kg/hr is better for the pt resulting in less hypotension, sudden cardiac death and overall the pt feels better.

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    I agree with extending his time.

    Is this a new patient? if so, is it disequilibrium syndrome?

    What is his albumin level with +3 BLE edema, and no SOB and clear lungs....if this is third spaced fluid, you are never going to get it off him without increasing his albumin level.

    There are many factors to look at to figure out where the h/a's are coming from.

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