J Korean Acad Nurs.  2016 Oct;46(5):642-652. 10.4040/jkan.2016.46.5.642.

The Effect of Dialysate Flow Rate on Dialysis Adequacy and Fatigue in Hemodialysis Patients

Affiliations
  • 1Artificial Kidney Unit, Bethesda Hospital, Yangsan, Korea.
  • 2Department of Nursing, Dong-A University, Busan, Korea. hsmin@dau.ac.kr

Abstract

PURPOSE
In this single repeated measures study, an examination was done on the effects of dialysate flow rate on dialysis adequacy and fatigue in patients receiving hemodialysis.
METHODS
This study was a prospective single center study in which repeated measures analysis of variance were used to compare Kt/V urea (Kt/V) and urea reduction ratio (URR) as dialysis adequacy measures and level of fatigue at different dialysate flow rates: twice as fast as the participant's own blood flow, 500 mL/min, and 700 mL/min. Thirty-seven hemodialysis patients received all three dialysate flow rates using counterbalancing.
RESULTS
The Kt/V (M±SD) was 1.40±0.25 at twice the blood flow rate, 1.41±0.23 at 500 mL/min, and 1.46±0.24 at 700 mL/min. The URR (M±SD) was 68.20±5.90 at twice the blood flow rate, 68.67±5.22 at 500 mL/min, and 70.11±5.13 at 700 mL/min. When dialysate flow rate was increased from twice the blood flow rate to 700 mL/min and from 500 mL/min to 700 mL/min, Kt/V and URR showed relative gains. There was no difference in fatigue according to dialysate flow rate.
CONCLUSION
Increasing the dialysate flow rate to 700 mL/min is associated with a significant nicrease in dialysis adequacy. Hemodialysis with a dialysate flow rate of 700 mL/min should be considered in selected patients not achieving adequacy despite extended treatment times and optimized blood flow rate.

Keyword

Renal Dialysis; Hemodialysis Solutions; Treatment Outcome; Urea; Fatigue

MeSH Terms

Adult
Aged
Blood Flow Velocity
Creatinine/blood
Dialysis Solutions/*chemistry
*Fatigue
Female
Humans
Male
Middle Aged
Potassium/blood
Prospective Studies
Renal Dialysis/*methods
Renal Insufficiency, Chronic/*psychology
Urea/blood
Creatinine
Potassium
Urea
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