Published
Thirst is a powerful, primitive, primal survival mechanism
Thirst simply cannot be resisted - no matter how much the patient tries.
The inevitable result ...?
Another 4 kg (4 litres) is gained and ... it all starts over again
http://www.nocturnaldialysis.org/lowbp.htm
The sad facts of a typical dialysis day (for most) ...
The patient struggles in for HD on a Monday morning after a 'long break', that weekend off for dialysis staff that forces a 68 hour break for without dialysis on each and every facility-based dialysis patient ...
The arrival scenario ...?
The patient is short of breath with a 'thumping' heart and a 4 kg weight gain in excess of the weight recorded at the end of the previous Friday's dialysis ... and remember: a 4 kg weight gain equates to a 4 litre retention of ingested fluid
The dialysis plan ...?
Remove 4 litres over 4 hours HD ... or about 1 litre/hour for every hour of dialysis
The dialysis result ...?
Cramp, nausea and a horrible 'flat' - that awful moment when the blood pressure drops and the eyes roll back in a dead faint
The treatment response ...?
A frantic 'revival' effort with intravenous (IV) fluid - when the whole object of the session has been to remove 4 litres of fluid
The treatment outcome ...?
The patient goes home, washed out, exhausted and thirsty-as-hell.
The rest of the day is 'written off' to allow recovery
Meanwhile ...
The patient immediately starts to drink fluid (when knowing its wrong) to slake a raging thirst.
Why ...?
Because a rapid reduction of blood volume stimulates
THIRST
With 6 night/week NHHD, it isn't like that at all ...
1. Imagine dialyzing (but while you sleep) ... for 8-9 hrs out of every 24 hrs
As NHHD is for 8-9 hours and not just 4, there more than twice as long to remove any excess fluid
2. Imagine dialyzing every 24 hrs, not just every 48-72 hrs
As NHHD is pretty much every night (6 times/week and not 3 times/week), fluid is also being removed twice as often
Do your mathematics ... it's quite simple really ...
Twice as long + twice as often = a 4 times slower rate of fluid removal
This means dialysis which is four times as gentle
NDXUFan
299 Posts
Yes, 3 times per week is not enough. Indiana University would argue that the bare minimum should be 5 days per week. Based on seven and half years on dialysis, I would have to agree with that assessment. Diabetic thirst is the worst thing on this earth. I had normal health for years and I can tell you that there is nothing like diabetic thirst. I would not wish it on anyone on this board, it is He!! on earth.