Tolerance To High Ultrafiltration Rates During Closed Batch Hemodialysis

Abstract
The tolerance to high levels of ultrafiltration that was observed when using a RP-6 dialyzer with polyacrylonitrile membrane and a closed batch dialysate delivery system has led patients to be placed on a free Na and fluid intake. Eight patients were put on such a diet for 6 mo. They have been dialyzed 4-5 h, 3 times per wk, on a RP-6-Rhodial 75. The mean intersession weight gain was 4.29 .+-. 0.18 kg after 3 days for a mean predialytic body weight of 63.55 .+-. 2.54 kg. Mean predialytic blood pressure was 138 .+-. 4 mmHg for systolic pressure and 82 .+-. 5 mmHg for diastolic pressure. Mean ultrafiltrate volume was 4.86 .+-. 0.36 l which corresponds to a Na output of 661.3 .+-. 49.5 meq. The K removal was 83.47 .+-. 5.72 meq. Total plasma protein and hematocrit increased 18.8 .+-. 3.34% and 19.13 .+-. 3.22%, respectively, when the pre- and post-dialytic values were compared. No clinical sign of fluid overload (dyspnea, edema, etc.) was noted in these patients. Cardiothoracic index remained in the normal range. This tolerance is possibly due to the high Na concentration (145 meq/l) in the dialysate. The free Na and water diet may contribute to a better rehabilitation.

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