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Weight loss and muscle weakness after dialysis. How to get cure?

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Practicing since : 2003
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As I have talked you earlier, My brother is on dialysis from the month of July.
Now, when he go for dialysis his weight around 60Kg after the dialysis his weight downs to 57 Kg and after the dialysis he feel so much weakness even he does not able to talk.
So in that case what we need to do?
Posted Tue, 12 Nov 2013 in Kidney Conditions
Answered by Dr. Aditya Bhabhe 48 minutes later
Brief Answer:
See detailed answer

Detailed Answer:
Hi there

Thank you for sending in your query.

If you could provide some background information about your brother, it will help me in providing more suggestions:
1) Does the patient have swelling on the feet or shortness of breath?
2) Does he pass urine and if so what is the amount?
3) What is his Blood pressure like?

Prima facie, his symptoms of weakness post dialysis can be due to the removal of excess fluids.

In this scenario we can do the following things:
1) See if his target weight needs to be moved upwards. It means he comes off at say 58kgs at the end of dialysis. This is seen if the patient has been putting on some real weight.

If the patient has been eating well or is passing large quantity of urine, then this often happens.

2) If he needs to come off at 57 kgs then we could do the following:

a. We need to reduce his weight gain between 2 dialyses by strictly cutting back on salt and restricting the fluid intake to match his urine output.

b. We could try to extend the dialysis time by 1 hour. By doing this we remove the same quantity of fluid over a longer time which makes it easier on the body.

c. The best option would be to increase the frequency of dialysis. We can have 4 sessions/ week or even do something called as short daily hemodialysis (SDHD).

By increasing the frequency we often have to remove less fluid in each session and this improves the patient's tolerability.

As your brother is only 38 years old the destination therapy should be a kidney transplant.

I hope this was helpful.
I will be happy to provide answers to any other questions.

Dr. Bhabhe
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