Sun Mi Cha; Hye Sook Min

doi:10.4040/jkan.2016.46.5.642

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Original Article
The Effect of Dialysate Flow Rate on Dialysis Adequacy and Fatigue in Hemodialysis Patients: Sun Mi Cha, Hye Sook Min; Journal of Korean Academy of Nursing 2016;46(5):642-652.
DOI: https://doi.org/10.4040/jkan.2016.46.5.642
Published online: October 31, 2016

¹Artificial Kidney Unit, Bethesda Hospital, Yangsan, Korea.

²Department of Nursing, Dong-A University, Busan, Korea.

Address reprint requests to: Min, Hye Sook. Department of Nursing, Dong-A University, 32 Daesin Gongwon-ro, Seo-gu, Busan 49201, Korea. Tel: +82-51-240-2872, Fax: +82-51-240-2872, hsmin@dau.ac.kr

• Received: January 22, 2016 • Revised: May 4, 2016 • Accepted: May 17, 2016

This is an Open Access article distributed under the terms of the Creative Commons Attribution NoDerivs License. (http://creativecommons.org/licenses/by-nd/4.0/) If the original work is properly cited and retained without any modification or reproduction, it can be used and re-distributed in any format and medium.

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Abstract
NOTES
REFERENCES

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.
Keywords: Renal Dialysis; Hemodialysis Solutions; Treatment Outcome; Urea; Fatigue

This manuscript is a condensed form of the first author’s master’s thesis from Dong-A University.

The authors declared no conflict of interest.

REFERENCES

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Table 1

General Characteristics and Hemodialysis-related Characteristics (N=37)

*Multiple response; AVF=Arteriovenous fistula; AVG=Arteriovenous grafts.

Table 2

Homogeneity of Blood Indices and Ultrafiltration Volume (N=37)

A: dialysate flow rate: twice as fast as the participant’s own blood flow; B: dialysate flow rate: 500mL/min; C: dialysate flow rate: 700 mL/min.

Table 3

Kt/V and URR Comparison by Dialysate Flow Rate (N=37)

A: dialysate flow rate: twice as fast as the participant’s own blood flow; B: dialysate flow rate: 500 mL/min; C: dialysate flow rate: 700 mL/min; URR=Urea reduction rate.

Table 4

Fatigue Comparison by Dialysate Flow Rate (N=37)

A: dialysate flow rate: twice as fast as the participant’s own blood flow; B: dialysate flow rate: 500 mL/min; C: dialysate flow rate: 700 mL/min.

Figure & Data

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

J Korean Acad Nurs. 2016;46(5):642-652. Published online October 31, 2016

DOI: https://doi.org/10.4040/jkan.2016.46.5.642

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

Table 1

General Characteristics and Hemodialysis-related Characteristics (N=37)

*Multiple response; AVF=Arteriovenous fistula; AVG=Arteriovenous grafts.

Table 2

Homogeneity of Blood Indices and Ultrafiltration Volume (N=37)

A: dialysate flow rate: twice as fast as the participant’s own blood flow; B: dialysate flow rate: 500mL/min; C: dialysate flow rate: 700 mL/min.

Table 3

Kt/V and URR Comparison by Dialysate Flow Rate (N=37)

A: dialysate flow rate: twice as fast as the participant’s own blood flow; B: dialysate flow rate: 500 mL/min; C: dialysate flow rate: 700 mL/min; URR=Urea reduction rate.

Table 4

Fatigue Comparison by Dialysate Flow Rate (N=37)

A: dialysate flow rate: twice as fast as the participant’s own blood flow; B: dialysate flow rate: 500 mL/min; C: dialysate flow rate: 700 mL/min.

Table 1 General Characteristics and Hemodialysis-related Characteristics (N=37)

*Multiple response; AVF=Arteriovenous fistula; AVG=Arteriovenous grafts.

Table 2 Homogeneity of Blood Indices and Ultrafiltration Volume (N=37)

A: dialysate flow rate: twice as fast as the participant’s own blood flow; B: dialysate flow rate: 500mL/min; C: dialysate flow rate: 700 mL/min.

Table 3 Kt/V and URR Comparison by Dialysate Flow Rate (N=37)

A: dialysate flow rate: twice as fast as the participant’s own blood flow; B: dialysate flow rate: 500 mL/min; C: dialysate flow rate: 700 mL/min; URR=Urea reduction rate.

Table 4 Fatigue Comparison by Dialysate Flow Rate (N=37)

A: dialysate flow rate: twice as fast as the participant’s own blood flow; B: dialysate flow rate: 500 mL/min; C: dialysate flow rate: 700 mL/min.