Kidney damage

[gremlinsmummy]

Has anyone else had kidney damage from HG? I was admitted to hospital earlier this week as my blood pressure was up a little and there was protein in my urine so the OB suspected Pre-eclampsia. When the blood tests came back tho, she said it's not PE, but it looks like my kidneys are struggling a little. I'm borderline dehydrated all the time due to not being able to keep up with the fluid loss from vomiting /ptyelism, especially in the mornings when I've gone 10 or so hours overnight without drinking.

The plan at this stage is to keep an eye on my kidney function, but other than delivery (which is still 10 weeks away), I can't see the situation improving and it worries me. I'm also worried about the possible long term effects on my kidneys, this prolonged dehydration can't be good for them.

Anyone else had similar issues?

[AnneCan]

Yep, HG can definitely cause long term issues with kidneys. It doesn't mean you'll have permanent damage, as things usually resolve themselves, but it is possible. Can you look into IV fluids until you deliver...to take the extra strain off your kidneys?

[MichellevsHG]

Did your doctor mention anything about IV fluids? How about a 24 hr urine collection? It sounds like you could use ongoing IV fluids until your kidney function stabilizes. Are you urinating?

In the meantime, I would start logging your fluid input and fluid output (puke episodes and urinating). I would get some ketostix from the pharmacy and start tracking your ketones as well.

Please keep us posted.

[gremlinsmummy]

I think here in Australia, the only option for IV fluids is as an inpatient which I'm obviously keen to avoid I was in hospital from 7-13 weeks on IV fluids and meds, but since then have been trying to manage at home on a vast cocktail of meds. With my twins we were in NZ and I had a homecare nurse come and give me fluids every day, but AFAIK that's not an option here. Every time I tell the OB I'm struggling, he just says I'm already on the max doses of everything. It sucks coz I reckon if I could have a couple of bags of fluids run every night I'd feel a million times better, and it would mean I wasn't waking up each day peeing orange sandpaper and with a dehydration headache. It takes me until about 3pm to get my fluid levels back up again. The stupid thing is, now they're worried about having to deliver baby prematurely if my kidneys don't hold out, you'd think fluids at home would be the perfect solution!

[gremlinsmummy]

My biggest fluid loss is actually from ptyelism, when I was in hospital they estimated I'm losing 750ml-1litre a day just from spitting (they weighed the tissues I spit into, I'm getting thru a box of 140 tissues a day), and the meds don't help that at all

Good idea about the ketostix, maybe I'll do that over the weekend and take with me to my next appt on Mon.

[teddi]

I don't understand, is there NO home health access there at ALL? Because I can't see how they couldn't get something going for you!

I would think that the simplest answer is put you in the hospital a few days, see if they can normalize your labs. Then insert a midline and send you home and set you up to do fluids at home. It would really be terrible if there is no way to make that happen.

If you need fluids, you NEED fluids, and nothing else is going to make your body happy. Another option: set you up with an infusion clinic and have you do fluids 3-4 times a week (every other day).

[gremlinsmummy]

I don't know, there must be something, I just don't know the system here as well as I know NZ having had 3 HG pregs there. But even when I was in hospital in first tri, there was never any discussion of me being allowed to go home on fluids, I had to stay in until I could manage without them.

It sucks, coz I literally do not have the energy to fight right now

[DebbieS]

I had mild kidney damage (and liver and other stuff) from my 2nd pregnancy. It took around 6 months after pregnancy to recover full function. Last pregnancy it also struggled a bit, but I was already under the care of a high risk Dr & on steroids (which can be used to help kidney function) & it remained mild. Whilst annoying, going in for fluids is probably the best thing you can do to help support them. Also ask your Dr lots of questions about it, & what your test results mean etc. I have wondered myself whether contacting a nursing company directly (the sort that do home visits for the elderly) or asking a GP/Dr about this system may work. So far, the only Australians I've heard of who have got IVs at home have had it administered by medically qualified friends/family.

[Hinano]

My kidneys are hurting right now and I'm hoping I don't end up with kidney troubles

I am in Australia and have just spent 8 weeks at home on daily IVs but it isn't normal here no.

My GP was willing to cannulate me and send me home so I could connect bags myself. It's not that hard to learn to change the bags over once someone has shown you. I think some of the US women change bags over themselves too.

Last preg I did it a couple of times and I was not a medical professional just had a GP who was understanding.

This time I am a midwife which helps with GP being comfortable with it and so I don't have to go to the GP twice a week I have had a friend come to my home and cannulate me. new IV cannula is needed every 3-4 days and if they come out or tissue you need a new one also. I still see GP at least every 1-2 weeks and get regular blood tests to check levels. I have also had times where I sit in GP surgery for a few hours getting fluids through and I just found out our local public hospital has an antenatal day stay area where they see women in business hours who need monitoring etc and will have HG women come in for the day for fluids. You need to have once gone through emergency and after that you can go straight to antenatal area each time. worth exploring some options.

[gremlinsmummy]

Thanks for the support I made the decision to come back to hospital this afternoon, and sure enough, 3+ ketones again. They had trouble getting a canula in and couldn't get enough blood off it to check my kidney function again, so I'm having 2l of fluid then they'll try and find another vein to get blood from. I think the midwife who admitted me thought I was being overdramatic, she kept asking how I knew I was dehydrated so seeing the ketones come up shut her up fast. She seems to think I'll be going home once the fluids have run, but I've got news for her - I'm not leaving til I have some kind of management plan in place. It sucks tho coz at the mo I'm in the delivery unit and in a room with two other women who are being induced - I am so jealous Hopefully I'll get moved to a ward overnight.

[MichellevsHG]

I am so glad to hear you're in the hospital. I agree that you need to stay until they have a plan for hydration for you. Remind them that meds will not work if your body is dehydrated. Please keep us posted!!

[Cin]

Stay put and insist on being seen by a physician -- midwives are experts in normal pregnancy, not high-risk HG pg when your kidneys are not functioning properly.

You can tell the cow I said that.

I hate when they get all uppity like that about dehydration. eye roll.

Hugs, and keep us posted, OK?

[gremlinsmummy]

I'm still here, got admitted to the ward as expected. One of the OB consults came to see me before I came down to the ward and she was really good. She said home fluids aren't really an option, but they have a day unit here where I can come aand get fluids every morning or every second morning depending on how I'm doing. I guess similar to what you're talking about Hinano?

They gave me 4 bags of fluid overnight and they're going to check my ketones again next time I pee to see how I'm going. I still feel quite dry but 100 times better than when I arrived.

This is all new to me tho, I'm used to first tri being like this but usually it settles around 16 weeks and I can manage at home coz the vomiting drops to once or twice a day. I've never had a third tri relapse before and it sucks!

[AnneCan]

Your hydration plan sounds like what they do here for me where I live (in Canada). We don't have HHC for hydration/HG treatment around here either. I do all my IV fluids in the outpatients area of the hospital. My doctor just schedules me to go in as often as needed, and I sit in a little room with other people getting IV therapy. I'd say if you have been dehydrated, and are having kidney pain, take the daily fluids for at least 2 weeks. You can try moving to every 2 days after that if you're feeling okay, but it takes a long time for your body to rehydrate properly and repair itself, especially when you're not getting enough in (or keeping enough in) everyday.

Good luck, I'm glad you stood your ground!! Big victory for you

[MichellevsHG]

So glad you are still there. I like AnneCan's idea about the infusion clinic. I think that is a great plan. Do not let them discharge you if you're still spilling ketones (doesn't sound like you'll let them ) Keep us posted!

[gremlinsmummy]

The ward rounds doctors came, they're keeping me til Mon at this stage so they can top me up to the brim and hopefully by then the ketones will be gone. Missing my kids like crazy, but I know I need to be here right now.

Thanks so much for all the support and advice, it's pretty lonely here on HG mountain so it's nice not to be alone.

[MichellevsHG]

I know you must miss your kids I can't imagine . . . but you are right where you need to be. Glad they are keeping you in until you are stable. And you're definitely not alone *hugs*

[teddi]

I'm glad they are treating you for this, and I am very sorry your options are limited and it means being stuck in a hospital bed

[AnneCan]

Sorry, it's so hard being in the hospital all alone...

Just make sure you keep getting fluids after you are discharged so you don't back track. It's completely worth the daily trips in (or every couple days), even if they are a pain in the bum. Hope you're feeling a bit better in a couple days. hugs

[gremlinsmummy]

I get discharged in 4 1/2 hours! Lol coz that's how much longer left on the last fluid bag they're running. Then back Thurs, Sat and Tues for fluid infusions, or more often if I need it. The doc also mentioned bringing the induction forward to 36 weeks, but I'm undecided as much as I want this hell to be over, I want to give my little girl the best start possible so if that means hanging in there til 38 weeks when I know she'll be 'done' (my other singletons were 38 weekers) then I just have to battle on.