Abstract
Background: High dialysate flow rates (Q<sub>D</sub>) of 500–800 mL/min are used to maximize urea removal during conventional hemodialysis. There are few data describing hemodialysis with use of mid-rate Q<sub>D</sub> (300 mL/min). Methods: We constructed uremic solute (urea, beta<sub>2</sub>-microglobulin and phosphate) kinetic models at varying volumes of distribution and blood flow rates to predict solute clearances at Q<sub>D</sub> of 300 and 500 mL/min. Results: Across a range of volumes of distribution a Q<sub>D</sub> of 300 mL/min generally yields a predicted urea spKt/V greater than 1.2 during typical treatment times with a small difference in urea spKt/V between a Q<sub>D</sub> of 300 and 500 mL/min. A larger urea KoA dialyzer and 15 min of additional time narrows the urea spKt/V difference. No substantial differences were observed regarding the kinetics of beta<sub>2</sub>-microglobulin and phosphate for Q<sub>D</sub> of 300 vs. 500 mL/min. Conclusion: A Q<sub>D</sub> of 300 mL/min can achieve urea clearance targets. Hemodialysis systems using mid-rate Q<sub>D</sub> can be expected to provide adequate hemodialysis, as currently defined.
Published Version
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