Monthly Dialysis Labs: A Surprising Number I Haven't Seen Since 2025
Every month during dialysis, I have a full set of lab work done. The nice part? No extra needle stick. The blood is drawn directly through the dialysis tubing while I'm already connected.
The monthly labs help monitor many aspects of living with End Stage Renal Disease (ESRD), including:
Potassium – helps reduce the risk of dangerous heart rhythm problems.
Creatinine – shows how well my kidneys are filtering waste.
Phosphorus – high levels can pull calcium from the bones, while levels that are too low can affect oxygen delivery to muscles and lead to weakness.
Iron
Hemoglobin
Sodium
Chloride
Carbon Dioxide
Total Serum Protein
Albumin
Magnesium
Platelet Count
White Blood Cell Count
The number I paid the closest attention to this month was BUN (Blood Urea Nitrogen).
Here's the simple version. When we eat protein, our bodies break it down, producing ammonia, which is toxic. The liver converts that ammonia into urea. Urea travels through the bloodstream to the kidneys, where healthy kidneys filter it into urine.
With ESRD, that process doesn't work very well, so BUN levels can rise because waste isn't being removed efficiently.
During dialysis, my care team measures BUN before treatment and after treatment to see how effectively the dialysis removes that waste.
When I reviewed my results on Saturday, July 18, something caught my attention.
For the first time, when my monthly labs were tracked starting in October 2025, my pre-dialysis BUN was in the normal (green) range.
Even more interesting, my post-dialysis BUN wasn't dramatically lower. Normally, I'd expect to see a much bigger drop after treatment.
So now I'm left with a few questions:
Are my kidneys somehow recovering a little?
Was this simply an unusually good month?
Did my diet or hydration affect the result?
Or was it just one of those lab quirks that occasionally happens?
The answer is... I don't know.
One lab result doesn't establish a trend, especially with ESRD. But after months of watching these numbers, seeing that green result definitely made me stop and smile.
I'll be watching closely next month to see whether this was the beginning of a trend or simply a one-time surprise.
Either way, I'll keep sharing the journey.
Dialysis Isn’t Just the “Hangover”
When people ask me what dialysis feels like, I often compare it to having a hangover.
Now, before anyone gets confused, I haven’t had an alcoholic beverage in more than 17 years. Recovery has been one of the greatest gifts of my life. But I do remember what a hangover felt like, and it’s one of the closest comparisons I can make.
That foggy feeling.
The fatigue.
The lack of energy.
The difficulty concentrating.
The feeling that my body just isn’t operating at 100%.
For me, dialysis can produce many of those same sensations. It’s as if someone hit the reset button on your body, but the operating system takes hours to fully boot back up.
But there are other reminders of dialysis that don’t get talked about nearly as often.
The photo with this post was taken immediately after one of my dialysis treatments. Those two puncture marks in my arm are where 15-gauge needles were inserted into my graft. During treatment, one needle carries blood from my body to the dialysis machine, where it’s filtered, and the other returns the cleaned blood back to me.
Every treatment.
Three times a week.
Week after week.
The machine isn’t just cleaning my blood. It’s also removing the small amount of excess fluid my kidneys can no longer remove on their own. Even when I carefully manage what I drink between treatments, there’s still fluid that has to come off.
Those needle marks are a reminder that dialysis isn’t just something I do—it’s something my body experiences.
In my case, I have an arteriovenous graft. Some people receive dialysis through an arteriovenous fistula, and depending on the individual, those access sites can become much more pronounced and visibly change over time. Everyone’s journey looks a little different.
When people see someone on dialysis, they often see the few hours spent sitting in a treatment chair.
What they don’t always see is what happens afterward.
The exhaustion.
The soreness.
The arm that reminds me of where two large needles were just inserted.
Planning my life around treatment schedules.
The mental adjustment of knowing I’ll be back in a couple of days to do it all over again.
I don’t write these posts for sympathy.
I write them because, unless you’ve experienced dialysis yourself—or cared for someone who has—it’s difficult to appreciate what life is really like between treatments.
If sharing my experience helps someone better understand what millions of people living with kidney disease go through, then it’s worth sharing.
And if it encourages even one person to consider becoming an organ donor, that’s even better.
Waiting for the Call
Three days a week, dialysis keeps me going. It also serves as a constant reminder that I'm waiting for something bigger.
This week, a fellow patient received a kidney transplant after about two years on the waiting list. Hearing that news gives hope to the rest of us still waiting for our turn.
I'm now keeping an overnight backpack ready so that when the call finally comes, I can grab it and head to the hospital.
Watch the full vlog:
https://www.nielflamm.com/videos/esrd