Friday, July 24, 2009

Phosphorus continues to baffle

Day before yesterday I started adding a phosphate solution to my dialysate so that too much Phosphorus is not removed from my blood during dialysis. The normal range for Phosphorus is 2.5 to 4.5 mg/dl. Mine has been between 1 and 2 mg/dl post dialysis.

I have been taking a phosphorus supplement called Neutraphos but it has not been helping too much because the removal of Phosphorus during dialysis was a lot.

Yesterday, post dialysis, my Phosphorus was only 1.1 mg/dl. This, after adding the phosphate solution to the dialysate. Yesterday, I had two packets of Neutraphos before dialysis. This morning it was 1.7 mg/dl.

I'm wondering if it is safe to increase the amount of phosphate solution further in the dialysate.


Miriam said...

E-mail John Agar and ask his opinion.

Dr.Hariharan Ramamurthy said...

if you are taking sensipar (cinacalcet it will not only reduce calcium and parathhormone levels but also your phosphorus levels

what are your calcium levels ?

also as a person who has been on dialysis for long and failrly well educated and interested in the general well being of Indians at large .
may be it is high time
you did some thing concrete to alleviate the problems of dialysisi in general .
let us start with hyderabad .
i am interested in some plans
because my brother inlaw
was recently diagnosed with stage IV renal failure.
and has been educated on the predialysis.
of course he has his own worries about the money involved.

after googling I have seen a number of hospitals talking about
his session cost of anywhere between 880to1400 Indian rupees.
what What t is your experience.
also, can you make a blog k post of the breakdown of costs her home hemodialysis.
how much or use pending on each and every single and simple item, including alcohol swabs, etc.

From your last name. I think you may have contacts. among the business community.

And probably somebody who is in the medical board Mahaveer hospital.
which I hear at present time turning away some of the patient's referred by the" aarogya shree scheme."
what prevents this hospital in adding more dialysis stations?
can you find out some details for me .

off the cuff .
a 12 station dialysisi center can run
between 60 to 65 sessions if run 24 /7
dpending on prime time and grave yard shift of 2 to 5 am
there can be varying rates .
so if 180 to 200 patients form a co operative and ask for govt grant / philanthraphic donations after they collect seed money equal to a years dialyisis payment
it should be feasible to start an indipendent stand alone dialysis center .
tell me what you think .

if sanghi textile mills people have the technology to produce polyestr yarn
they should also be able to make Hollow fiber, which is the main ingredient of the dialyzer. one of the major expense to components in dialysis.

Unless we start manufacturing indigenously all the components after dialysis with in India. we can never achieve even 70% of the patients needing dialysis getting it

Kamal Shah said...

Hello Dr. Ramamurthy,

Thank you for your comment.

Yes, I agree that a lot needs to be done in this area. But the problem is the costs. The initial investment for a dialysis center is huge. Also, running the center is a big responsibility.

I have often mulled getting into this. But honestly, I do not think I have the wherewithal to do so. I am not medically qualified and this kind of work requires someone who is able to put in a lot of effort.

I have envisaged a dialysis unit where people actually look forward to coming and getting very comfortable dialysis mixed with entertainment which will help to ease some of the pain associated with dialysis.

Unfortunately, at this point in time, I am unable to put in the required effort for this.

I will however be happy to assist you in any way I can.


Dr.Hariharan Ramamurthy said...

of course it is quite difficult to anything without money.
and when the govt is having two standards every one wants free meal.

Dr.Hariharan Ramamurthy said...

when there is excess action of parathyroid and PTH levels are high in what is called primary hyperparathyroid and after surgery the PTH drops

and the bones start absorbing calcium and phosphorus

and there cann be very low ca and PO$

this is called the hungry bone syndrome

and a similar syndrome (condition is described when cinacalcet is used)
you may need to adjust your cinacalcet dose and if you are still taking any phosphate binders like phoslo or sevelamer did you stop taking them or not ?

Dr.Hariharan Ramamurthy said...

by the way there is a registry for peritoneal dialysis maintained by dr. vivekanand jha from PGI Chandigarh .
check Google Indian peritoneal dialysis registry

may be some body could correspond with him to see why this can not be extended to hemoduialysisi and with so many software firms working in hyderabad why some firm can not offer to host a server for this .

Kamal Shah said...

Hello Dr. Ramamurthy,

No, I am not taking any phosphate binders. I am taking cinacalcet 30 mg thrice a week.

I will try and find Dr. Jha's PD registry. Thanks for the info.