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The Effect of Increasing Blood Flow Rate on Dialysis Adequacy in Hemodialysis Patients with Low Kt/V

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Abstract:

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.

Document Type: Research Article

DOI: https://doi.org/10.1111/j.1492-7535.2004.0085q.x

Affiliations: Department of Internal Medicine, The Catholic University of Korea, Seoul, Korea.

Publication date: 2004-01-01

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