I came across info that total protein post tx should be 8 something. My labs say mine is only 6 something. That means that fluid is not removed fully enough during the tx. To achieve more complete fluid removal conductivity should be at leaste 14.5, ph 7.4.(mine runs 14.2-14.3). I am on a Fresenius 2008H and my sodium rate is 140. Are there bicarb and acid solutions that will work with these figures to give me a conductivity of 14.5? Can the machine be calibrated to achieve that high a conductivity? As biotechs, are you familiar with the relationship between total protein and fluid loss?

quote:

Originally posted by Greg:

I came across info that total protein post tx should be 8 something. My labs say mine is only 6 something. That means that fluid is not removed fully enough during the tx. To achieve more complete fluid removal conductivity should be at leaste 14.5, ph 7.4.(mine runs 14.2-14.3). I am on a Fresenius 2008H and my sodium rate is 140. Are there bicarb and acid solutions that will work with these figures to give me a conductivity of 14.5? Can the machine be calibrated to achieve that high a conductivity? As biotechs, are you familiar with the relationship between total protein and fluid loss?

Greg, you have some interesting questions but are a little confusing. When you say your protien should be 8 but your lab says it is only 6 what exactly are you talking about. You should not be losing protein during your treatments. As for fluid removal you cannot base it upon your protien. Sufficient fluid removal depends on reaching your goal at the end of the treatment. If you are not getting enough fluid removal you will experience shortness of breath, higher bp's and maybe some wheezing. If you feel your dry weight needs to be adjusted then talk to the doc. about that. Changing your base sodium to 145 will not be the answer to remove more fluid, since you mentioned in a previous topic that it makes you thirsty. What you can try is a variable sodium program together with a UF profile and if your facility has a BVM (blood volume module) use it at the same time. The BVM is excellent at finding out if you are still fluid overloaded. The conductivity can be adjusted in the dialysate screen to a base as high as 155 but don't even try it and the bicarb to 40.

Gizzman,

Normal range total protein post tx is 8-9. 6 is too low, means fluid removal is not enough.

> As for fluid removal you cannot base it upon your protien.
You can, you have to base fluid removal upon blood total protein post session.

Just my opinion.

This indicator of fluid status is new to me and I have lots of questions. Can you tell me where I can read more about this?

Don't find many things on the net about relationship between fluid removal and total protein post tx.
Maybe this help ?
http://www.multi-med.com/homehemo/1600/main.html

How would you monitor total protein...with a lab draw q Rx? If you are using TP as a marker for fluid removal are you using it as an indicator of hemo-concentration..if so there are other indicators like Hct that also vary with hemo-concentration (this is why Hgb. is used as marker for anemia mgt.)
I guess I am confused and would be hesitant
to disavow well known clinical assessments
used for dry weight dtermination.