My father is on dialysis and appears to have lost his appetite for food. Even talking about food causes nausea. He has lost over 20 pounds in the last month. He complains that everything has no taste or that everything makes him nausous. Any suggestion to stop this feeling
of nausea or improve the taste of the food?
Send replies to Lsenz@aol.com

thanks

SGS

How long has your dad been on dialysis?

I, for example, have been on hemodialysis for about three years now. During the first year, I lost about a fifth of my bodyweight because of a loss of appetite and nausea.

Eventually, my appetite did come back, but I cannot attribute it to any single event.

Your father's doctor can consider prescribing an appetite stimulant like Megestrol. In the meantime, I would recommend he consider a nutritional supplement such as Boost or Ensure. Another, called New Basic VHP, is particularly good. The VHP stands for "very high protein."

Mike

If you haven't already done so, ask to talk with the dietitian at your father's dialysis clinic. She/He can help evaluate what is causing your father's loss of appetite and nausea and suggest ways to overcome this. Nutrition is extremely important to maintaining health and survival. The National Kidney Foundation is going to be releasing guidelines on nutrition this fall. You can contact the NKF for more information at (800) 622-9010 or look at their web site at http://www.kidney.org.

Something that can cause a patient to feel nauseated and have a poor appetite is inadequate dialysis. You can tell if your father is getting good dialysis by lab reports that he should be getting from his dialysis unit. The unit should be measuring either URR or Kt/V. According to dialysis adequacy guidelines released by the NKF, your father is getting adequate dialysis if his URR is 65% or better. His lab results for Kt/V if he's on hemodialysis should be 1.2 or higher. If he is on CAPD (4 bags daily), his Kt/V should be 2.0 or better per week. If he is on CCPD (overnight peritoneal dialysis), his Kt/V should be 2.1 or better per week. Dialysis adequacy (hemodialysis) can be affected by the dialysis treatment length, whether your father comes to and stays for the whole treatment, the size of dialyzer, and how well his dialysis access is working. For peritoneal dialysis, adequacy can be affected by the treatment prescription itself, whether the patient is doing dialysis as prescribed, and how well the peritoneal membrane is working at transporting waste products from the blood to the dialysis solution.

Your father may also be depressed. Depression is common among new dialysis patients. Your father may wonder if life is worth living now that he has to do dialysis. The social worker can help him look at what gave him pleasure before dialysis and, along with established patients, he/she can help him see that there are still many things that will probably be able to do on dialysis.

Lack of activity also contributes to poor appetite. Inactivity contributes to weakness and a feeling that you can't do what you want to do, which then makes depression worse. If you don't watch it, it's a vicious cycle and one that needs to be stopped early.

It sounds like your father is lucky to have someone like you who cares about him.

Hello;

My Mom's appetite has rebounded somewhat after six months of settling into dialysis, and she feels less nausea. She has also gotten used to the dialysis routine and the superb care she receives. Quality care is what is most important and that is achieved by asking questions and asking for information steadily. I always struggle with how involved to be, however at the moment a question or need for information arises, I act on my Mom's behalf.

Because of dialysis my Mom and I have grown so close in love and friendship. While the experience has its challenging moments, I always focus on the caring and loving relationship I have with my Mom.

All the best, Joanne