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Effect of dialysis dose and membrane flux in maintenance hemodialysis.
Although later studies have not confirmed these findings, increased dialysis dose has been associated with better treatment and patient survival (Marshall et al.
Novel algorithms for measuring concentration of water soluble small molecular weight uremic toxins, urea, uric acid, and creatinine, in the spent dialysate for the estimation of dialysis dose and nutritional status (protein nitrogen appearance and lean body mass) on dialysis patients were developed [51-53].
Measures such as mortality rates, hospitalization rates, transfusion rates, and dialysis dose adequacy can be considered for inclusion if differences in quality of care in the production of dialysis services are to be understood and controlled for.
The most popular clinical parameters from urea kinetic modelling (UKM), characterizing dialysis adequacy, are the dialysis dose Kt/V and the normalized protein nitrogen appearance nPNA.
Patients in the Hemodialysis (HEMO) study who received a dialysis dose higher than that recommended by the National Kidney Foundation guidelines, or who were dialyzed using high-flux filters neither lived substantially longer nor had fewer hospital stays than those who received the currently recommended standard dose or were dialyzed with low-flux filters.
The randomized, controlled study showed that educating physicians and patients about these barriers resulted in a twofold increase in dialysis dose compared to conventional care.
The target dialysis dose for each patient was monitored using the more accurate and validated expression of equilibrated Kt/V, or eKt/V, which is derived from the traditional single-pool Kt/V (spKt/V) and time on dialysis.
The dialysis dose can be increased by using a larger bag, but only within the limit of the amount your abdomen can hold.