Dry Weight and Blood Pressure
http://nephron.com/lundin/lundin_dryweight.html
Copyright
©
1997 Andrew Lundin, M.D. All rights reserved.
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- Dry weight is the post dialysis weight at which one can
come to the next dialysis treatment with a normal blood pressure (<130/90
mmHg) and not require blood pressure medications. Controlling blood pressure
is essential to long life after ESRD. The cause for most is the few or many
extra pounds of water retained between treatments. Getting to true dry
weight often involves cramping and symptoms of low blood pressure
(relative), but over a limited time span. You can have cramps and still be
over your dry weight, particularly if you have to remove over 6 to 7 lbs
between treatments.
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- By the way, real tissue weight is not gained or lost
rapidly, except in the latter case if one is starving or infected. That
seven pounds gained in 3 weeks is mostly water and will probably make the
blood pressure go up. Depending on one's size, up to 15 to 20 lbs of water
can be stored in the body without being obvious except for the increase in
blood pressure. Most patients can have normal blood pressures on dialysis
without having to use blood pressure medications (with all their side
effects) if they get and maintain a true dry weight. Any subsequent
increases in blood pressure represent loss of real weight and decreases of
blood pressures indicate a gain in dry weight.
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- This theory is at present actively promoted by Dr. Belding
Scribner (37 years of medical experience), and by Dr. Bernard Charra who can
show an 85% 10 year survival in his patients in Tassin, France.
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- To reemphasize
- Most patients who gain much weight in a short period of
time will be retaining water and will note that their blood pressure goes
up, a sure sign that they need to take fluid off.
- A lot of water can be stashed in the body without one
being aware of it.
- Most patients can have normal blood pressures on dialysis
without having to use blood pressure medications if they get and maintain a
true dry weight.
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- Peter Lundin, M.D.
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- Minor editing and narration by Stephen Z. Fadem, M.D.
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- Here are some references regarding Dr. Charra's work in
Tassin, France (-ed):
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- Charra
B, 1996, Clinical assessment of dry weight. Nephrol Dial Transplant 11,
16-19 (1996)
- Charra
B, 1996, Importance of treatment time and blood pressure control in
achieving long-term survival on dialysis. Am J Nephrol 16(1), 35-44 (1996)
- Charra
B, 1994, Control of blood pressure in long slow hemodialysis. Blood Purif
12(4-5), 252-258 (1994)
- Charra
B, 1992, Survival as an index of adequacy of dialysis. Kidney Int 41(5),
1286-1291 (1992) Charra
B, 1992, Dose of dialysis: what index? Blood Purif 10(1), 13-21 (1992)
Remember, this information is for education purposes only.
Please consult your own physician for specific treatment recommendations. All
medical and therapeutic decisions must come from your health care provider.The
information obtained through this service, and the information which you receive
through the Internet is only for general guideline purposes, and is not an
ultimate source of information, nor something which you should rely on as a sole
source for your medical care. The authors, editors, producers, sponsors, and
contributors shall have no liability, obligation or responsibility to any person
or entity for any loss, damage, adverse consequence alleged to have happened
directly or indirectly as a consequence of this material.
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