Dry Weight and Blood Pressure

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.

 

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 presssures on dialysis without having to use blood pressure meds (with all their side effects) if they get and maintain 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.

 

This theory is at present actively promoted by Dr. Belding Scribner (37 years of medical experience), and by Dr. Bernard Charra who can show a 85% 10 year survival in his patients in Tassin, France.

 

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 presssures on dialysis without having to use blood pressure meds if they get and maintain true dry weight.

 

 

Peter Lundin, M.D.

 

Minor editing by Stephen Z. Fadem, M.D.

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Here are some references regarding Dr. Charra's work in Tassin, France (-ed):

 

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)

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