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The Effect of Increasing Blood Flow Rate on Dialysis Adequacy in Hemodialysis Patients with Low Kt/V
Author(s) -
Kim Y.o.,
Song W.j.,
Yoon S.a.,
Shin M.j.,
Song H.c.,
Kim Y.s.,
Kim S.y,
Chang Y.s.,
Bang B.k.
Publication year - 2004
Publication title -
hemodialysis international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.658
H-Index - 47
eISSN - 1542-4758
pISSN - 1492-7535
DOI - 10.1111/j.1492-7535.2004.0085q.x
Subject(s) - medicine , hemodialysis , dialysis adequacy , dialysis , kt/v , blood flow , urology , surgery , cardiology
Dialysis adequacy indexed by Kt/V in hemodialysis (HD) patients is recommended as a single‐pool Kt/V of at least 1.2 per session thrice weekly. But many patients cannot achieve this adequacy target. Although dialysis time is the most important as a factor influencing Kt/V, it is difficult to prolong dialysis time in practice because of its economic impact and poor patient compliance. Objective: The aim of this study is to investigate the effect of increasing blood flow rate on dialysis adequacy in HD patients with low Kt/V. Methods: This study enrolled 36 HD patients with single‐pool Kt/V <1.2 per session thrice weekly, which was measured in dialyzer blood flow rate of 230 mL/min. We increased 15% of blood flow rate in patients <65 kg of body weight and 20% in patients >65 kg. And then we compared Kt/V and urea reduction ratio (URR) between before and after increasing blood flow rate. Results: The mean age was 48 ± 11 years (23–73 years), and the number of males was 25. Of the total patients, 24 patients had dry weight <65 kg. Mean dialysis duration was 52 ± 50 months (3–216 months). Mean Kt/V before increasing blood flow rate was 1.02 ± 0.09. It increased to 1.14 ± 0.12 after increasing blood flow rate (p < 0.001). Of the total 36 patients, 13 patients (36.1%) achieved adequacy target (Kt/V ≤ 1.2). Mean URR before increasing blood flow rate was 56.9 ± 4.0%. It also increased to 60.8 ± 4.1% (p < 0.001). Conclusion: Our data suggest that increasing blood flow rate by 15–20% of previous flow rate is effective in achieving dialysis adequacy in HD patients with low Kt/V.