E-mail| Contact Us| Volunteer| Make A Gift| En Español| Employees



Our Services

Renal Dialysis

Renal Dialysis > Your Care

Your Care


Understanding Your Monthly Lab Work


Your blood work is an important tool. It tells you how you are doing with your diet and medications. It may show the doctor that something needs to be changed to keep you at your healthiest. It is like your "internal report card.” The following are some of the key lab studies performed on a regular basis and what information they give you as well as a list of common dialysis medications.
 

Please scroll down for Common Dialysis Medications and IV Medications.


Key Lab Studies


Albumin
Albumin is a substance made in the body from the protein that we eat. Monitoring the level of albumin in your blood can tell us a lot about your nutritional status. We need adequate levels of albumin to heal wounds, fight off infections, and keep us in generally good health.
 

Normal levels: 3.9-5.1 mg/dl
Accepted levels: 3.5-5.2 mg/dl


Blood Urea Nitrogen (BUN)
Blood urea nitrogen is what is left from protein that you eat after the body breaks it down. For example, when wood is burned in a fireplace, ashes are left over. Think of BUN as the ashes. With normal kidney function your body excretes the urea in the urine. In renal failure, BUN is more and more difficult to excrete and higher levels remain in the bloodstream. Your nephrologist uses this test to evaluate kidney function before dialysis is needed. When you start on dialysis, the BUN can tell us how well dialyzed you are and also how well you are eating. Blood urea nitrogen levels drawn at the beginning of the treatment compared to the levels drawn at the end of the treatment can tell us the "adequacy of dialysis."
 

Normal levels: 7-20mg/dl
Accepted levels on dialysis: 50-100 mg/dl


Calcium
Calcium is another mineral found in the body. It is primarily found in dairy products. Calcium is also a primary ingredient in medications such as Phoslo and Calcium carbonate. We need a certain amount of calcium to maintain proper bone growth, for metabolism and for other functions of the body. We need the active form of Vitamin D to absorb calcium properly.
 

Normal levels: 8.4-10.0 mg/dl
Accepted levels: 9.5-11.5 mg/dl


Creatinine
Creatinine is a substance made by normal muscle metabolism. This waste product is more constant compared to BUN and not as greatly influenced by the amount of protein that you have recently eaten. Creatinine is normally excreted into the urine. Before dialysis is needed for treatment, this measurement can tell the nephrologist how well the kidneys are functioning. Once dialysis becomes a necessary treatment, it can tell us how well you are being dialyzed.
 

Normal levels: 0.6-1.1 mg/dl
 

Accepted levels on dialysis: <12mg/dl (hemo)

<18 mg/dl (PD)


Ferritin
Ferritin is the body's storage of iron. Iron is needed for the production of red blood cells. An adequate level of iron is needed for the medication, EPO, to be able to make the red blood cells.
 

Normal levels: 42-135 ng/ml
Accepted levels: 100- 800 ng/dl


Hemoglobin
Hemoglobin is the iron-containing substance within red blood cells you have within your blood system. Its function is to carry oxygen from the lungs to cells in your body. Anemia, or low levels of hemoglobin, is one of the problems seen with chronic kidney failure. If a person is anemic, he or she may feel tired, cold or short of breath when doing daily activities. Some people may also have chest discomfort. Your medication, EPO, is given at the end of hemodialysis. It is given through the medication port of your dialysis tubing or given as an injection in your arm. EPO works to increase the number of red cells the body makes. When the hemoglobin is within the correct range a person is more likely to feel better.
 

Normal levels:
males: 14-18 g/dl
females: 12-16 g/dl
Accepted levels on dialysis: 11-12 g/dl


Phosphorous
Phosphorous is a mineral that is found primarily in meats, dairy products, and dried beans. We need this important mineral for our bodies to have strong bones and teeth. Phosphorous is often not secreted in the urine as efficiently as it should be in renal failure. This allows higher than normal amounts of phosphorous to build-up in the blood. High levels in the blood cause the body to decrease the absorption of calcium through the stomach wall. This can further lead to an over-active parathyroid gland, which can lead to bone disease. Symptoms of a high phosphorous level can be itching of the skin, bone discomfort, and redness of the whites of the eyes. Taking your phosphate binders with your meals, if prescribed, can decrease your absorption of phosphorous and keep it at acceptable levels.
 

Normal levels: 2.5-4.5 mg/dl
Accepted levels: 4.0-6.0 mg/dl


Potassium
Potassium is important to us for proper muscle function, especially for our heart muscle. A potassium level that is too high or too low interferes with the function of our muscles. Poor renal function often leads to the body not excreting enough potassium in the urine. It is more common for potassium levels to be higher than normal, so restricting your intake of potassium foods is often recommended. This mineral is found in most foods, but at higher levels in fruits and vegetables. For example: bananas, oranges, tomatoes, potatoes, and salt-substitutes made of potassium chloride contain potassium. Your doctor and dietitian will advise you of the amounts allowed in your diet.
 

Normal levels: 3.5-5.1 mg/dl
Accepted levels: 3.5-5.0 mg/dl


Transferrin Saturation % (Iron Sat)

Transferrin saturation is the measurement of available iron which can be more readily used in making of red blood cells. This is also needed in adequate levels for the medication, EPO, to make the red blood cells.
 

Normal levels: 20-50%
Accepted levels > 25% 


Common Dialysis Medications


PHOSPHATE BINDERS:

Taken with food, these medications bind with the phosphorus in your diet and then the phosphorus is excreted through your bowels.

Examples:

  • Basaljel (aluminum carbonate)

  • Phoslo (calcium acetate)

  • Os-Cal

  • Tums (calcium carbonate)

  • Renagel

Reminders:

  1. These medications must be taken with food in order to be effective.

  2. They should not be taken at the same time as iron pills. Take iron pills between meals.

  3. Phosphate binders can be constipating, so be aware of bowel function and use stool softeners as directed.

  4. High phosphorus levels in your blood can cause generalized itchiness, so take this type of medication to help prevent this.

  5. High phosphorus levels can make your body pull calcium from the bones, which weakens them.

  6. Occasionally, these medications are ordered only as antacids; then they are not to be taken with food, but this would be explained to you by your nurse/physician.


VITAMINS

Vitamin supplements are essential for you to take due to your dietary restrictions and because vitamins (water soluble) are washed out during your dialysis treatments.

Examples:

  • Vitamin B Complex with C

  • Nephrocaps, Nephro-Vite

  • Folic Acid

Reminders:

  1. Vitamins should be taken after your dialysis treatments.

  2. They can be taken with food to decrease stomach upset, if this should occur.

  3. Vitamins are much more important for you to take compared to the general population, so have them refilled immediately.

  4. Only take the vitamins prescribed by your physician because these are specifically for dialysis patients. Do not take over-the-counter vitamins.


SYNTHETIC VITAMIN D

This medication helps to increase the level of calcium in the blood. This will prevent calcium from being pulled from the bones.

Examples:

  • Rocaltrol or Hectoral

Reminders:

  1. This medication should be taken after dialysis treatments.

  2. Your calcium and phosphorus levels will be checked periodically and you will be told to withhold taking this medication, if necessary, as over-dosage is dangerous.


IRON SUPPLEMENTS

These medications are needed to treat low levels of iron in your blood, and to work with Epogen (EPO) to increase your blood count and hemoglobin in treating your anemia.
 

Examples:

  • Ferrous sulfate

  • Niferex-150 capsules

  • Nephro-Fer

  • Chromagen

Reminders:

  1. Do not take iron with phosphate binders.

  2. These medications are best taken on an empty stomach one hour before, or two hours after meals. Do not crush or chew iron pills.

  3. Iron can cause stools to turn black in color. This is not harmful.

  4. Iron can be constipating. Be aware of bowel function and use stool softeners/laxatives as directed, and only use those ordered by your doctor.

  5. Sometimes IV iron is given during dialysis treatments; you will then be instructed to stop your oral iron pills until IV therapy is completed.


STOOL SOFTENERS

This medication is given to prevent the formation of hard stools and constipation.

Examples:

  • Colace (docusate sodium)

  • DSS (dioctyl sodium sulfosuccinate)

  • Fibercon

Reminders:

  1. Stool softeners should be taken everyday to have a stool softening effect.

  2. Stool softeners are usually given to prevent constipation often caused by iron and phosphate-binding medications.

  3. Stool softeners can be taken before or during dialysis, as they are not affected by it.


LAXATIVES

These medications are taken to treat constipation by stimulating your bowels to move.

Examples:

  • Pericolace

  • Dulcolax

  • Sorbitol

Reminders:

  1. Laxatives should only be used when necessary.

  2. Do not take these regularly as your body can become dependent on their use.

  3. Constipation can become a serious problem for dialysis patients, so report to your nurse or physician if your current laxatives are not effective for you.


ANTICOAGULANTS

This medication slows the time it takes your blood to make clots. These clots can cause a serious medical problem. Anticoagulants help keep clots from forming, and are taken by patients with heart valves and/or rapid heart rate, or to help keep your dialysis access open.

Example:

  • Coumadin

  • Plavix

Reminders:

  1. Your physician has ordered the level of anticoagulant you should have. Adequate levels are measured by “INR” tests. Each patient has a determined INR level; you should know your target level.

  2. Dosages are often changed according to a blood test called Protime/INR, which is taken periodically. Make sure you take the right dose as prescribed. You may choose to use a calendar to keep track of when you are scheduled to take your medicine.

  3. Tell your nurse or physician when you get sick, hurt, or have a cut that won’t stop bleeding.

  4. Tell anyone giving you medical or dental care that you are taking Coumadin. You may want to wear a Medic Alert bracelet with this information.

  5. Report nose bleeds, bruising, excessive bleeding when brushing your teeth or during menstrual periods, etc.

  6. Take your Coumadin at the same time each day-always after your dialysis treatments.

  7. Coumadin must be stopped before any procedures that can lead to bleeding. Check with your physician.


ANTIHYPERTENSIVES (Blood pressure medication)

These medications are used to lower your blood pressure. Blood pressure in a dialysis patient is often hard to control because of large weight gains and losses. Blood pressure pills often are adjusted frequently so it is very important to check with your nurse or physician on the correct dose and times to be taken.

Examples:

  • Cozaar

  • Clonidine (Catapres)

  • Procardia (Adalat, Nifedipine)

Reminders:

  1. It is important to take your blood pressure medication as prescribed. Times for taking your blood pressure pills often need to be adjusted in relation to your dialysis treatments. Be sure you understand when they are to be taken.

  2. If you do not feel well on your medication (dizziness, swelling, coughing, rash, shortness of breath, headache, nausea, etc.) inform your nurse or physician immediately.

  3. Do not stop taking your blood pressure medication without checking with your physician first. Just stopping your medicine can cause blood pressure to go very high quickly.

  4. Many over-the-counter medications can increase your blood pressure. Do not take any medications not prescribed by your physician.

  5. Home blood pressure monitoring is important. If you do not know how to take your blood pressure, we will assist in teaching you.


ANTIHISTAMINES

These medications are given to treat any itching that you may experience.

Examples:

  • Atarax

  • Vistaril

  • Periactin

Reminders:

  1. Be aware that these medications may cause drowsiness. You may need to avoid activities that require alertness and good coordination, such as driving.

  2. These medications may cause dry mouth. You can use sugarless hard candy or gum to relieve dry mouth instead of fluids.

  3. Keeping your calcium and phosphorus levels under control can prevent some itching.

  4. Body lotions can be used for dry skin.

  5. Keep your fingernails short and do not scratch your skin, especially over your access (graft or fistula).


SPECIAL REMINDERS

  1. Do not take over-the-counter medications without asking your dialysis nurse or physician.

  2. Do not take Alka-Seltzer, baking soda or other bubbling remedies, as they are very high in sodium.

  3. Milk of Magnesia, Maalox, and Magnesium Citrate contain magnesium and should not be used.

  4. Aspirin affects clotting times of the blood and may cause bleeding, so only use if directed by the physician.

  5. These medications are only a few of the common dialysis medications. You may have been prescribed additional or different ones to meet your individual needs. This information is not designed to replace medication teaching by your dialysis nurse and physician. Please ask questions of your dialysis staff.


IV Medications


These are intravenous medications that the dialysis nurses may give to you while you're undergoing dialysis. The medication is injected into your blood lines during your dialysis treatment.

Examples:

  • Infed, Dexferrum, and Ferrlecit

  • Calcijex and Zemplar

  • Epogen and Procrit

Infed, Dexferrum and Ferrlecit are intravenous iron supplements that help to raise your iron level, and thus helps to make EPO more effective in treating your anemia. You will be instructed not to take your iron pills during Infed, Dexferrum or Ferrlecit therapy. A test dose will be given prior to administration because severe reactions have been reported on rare occasions (chest pain, difficulty breathing, shock, etc.). These reactions usually occur within the first few minutes after receiving the medication, so your nurse will observe you for any reaction and have medications ready to counteract any potential problems. IV iron may also cause abdominal pain, nausea, vomiting, and diarrhea.
 

Calcijex and Zemplar are intravenous forms of Vitamin D that stimulates calcium absorption through the stomach wall. Since Calcijex and Zemplar replaces your body's own inadequate supply of Calcitriol, they will lower PTH levels and help increase calcium in your blood. This helps to avoid, or at least slow down, renal bone disease. Some possible side effects of Calcijex or Zemplar include the possibility of blood calcium levels getting too high, or that too much vitamin D might build up in your body. Your blood will be periodically tested (calcium, phosphorus, PTH levels) and your Calcijex or Zemplar therapy may be stopped for a time if the levels are too high. You might experience a metallic taste in your mouth during Calcijex injection. If this occurs, tell your nurse. This can be fixed by slowing the rate of giving the medication.
 

Epogen (EPO) and Procrit contain a hormone that stimulates your bone marrow to produce red blood cells. It is given to you to treat the anemia that is caused by kidney failure. Its effectiveness is determined by your hematocrit blood level. Your EPO dosage will be adjusted according to your hematocrit levels. As your hematocrit increases, you may experience an improved sense of well-being.

 

 


 
 





Learn More

 
Find A Doctor
Advanced Search
Call 1-888-LGH-INFO
 

Locations



 

Contact Us:

1-888-LGH-INFO (544-4636) Have a question?
Follow us online.