Clinical nephrology · 2025
Effect of lower dialysate flow rates on quality of life and metabolic parameters in hemodialysis.
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Coritsidis George, Woda Craig, Papademetriou Demetrios, Aragon Michael, Lim Brittany, Singh Anun
Аннотация
INTRODUCTION: This study explored the efficacy of lower dialysate flow rates (Qd300 mL/min) on quality of life (QoL) outcomes in end-stage renal disease (ESRD).
MATERIALS AND METHODS: A prospective trial was conducted in participants receiving maintenance hemodialysis following a diagnosis of kidney failure who were currently stable with a dialysate flow rate ≥ 500 mL/min. Participants were transitioned to Qd300 for 4 - 8 weeks and were assessed for clinical outcomes including the Edmonton Symptoms Assessment System (ESAS), Kidney Disease QoL (KDQoL-36), "time to recovery" (TTR), and an array of metabolic parameters, including measures of dialysis efficiency.
RESULTS: A total of 41 participants were enrolled with a mean dialysate flow rate of Qd748. The majority of participants were male (65.8%) of Hispanic race (51.2%), had a mean age of 55.4 years (SD 11.5) with an average weight of 66.8 Kg (SD 12.39). Significantly improved KDQoL (3 of 5 components) was observed in participants transitioned to Qd300 as well as a trend towards improved TTR and ESAS by 4 weeks (p < 0.05). Extension of Qd300 for 8 weeks showed significant QoL improvements in 4 of 5 KDQoL components.
CONCLUSION: Modification of lower dialysate flow rates in participants receiving maintenance hemodialysis results in stable and improved KDQoL outcomes. Lower dialysate flow rates theoretically may aid in reducing financial costs and improve water conservation efforts.
MATERIALS AND METHODS: A prospective trial was conducted in participants receiving maintenance hemodialysis following a diagnosis of kidney failure who were currently stable with a dialysate flow rate ≥ 500 mL/min. Participants were transitioned to Qd300 for 4 - 8 weeks and were assessed for clinical outcomes including the Edmonton Symptoms Assessment System (ESAS), Kidney Disease QoL (KDQoL-36), "time to recovery" (TTR), and an array of metabolic parameters, including measures of dialysis efficiency.
RESULTS: A total of 41 participants were enrolled with a mean dialysate flow rate of Qd748. The majority of participants were male (65.8%) of Hispanic race (51.2%), had a mean age of 55.4 years (SD 11.5) with an average weight of 66.8 Kg (SD 12.39). Significantly improved KDQoL (3 of 5 components) was observed in participants transitioned to Qd300 as well as a trend towards improved TTR and ESAS by 4 weeks (p < 0.05). Extension of Qd300 for 8 weeks showed significant QoL improvements in 4 of 5 KDQoL components.
CONCLUSION: Modification of lower dialysate flow rates in participants receiving maintenance hemodialysis results in stable and improved KDQoL outcomes. Lower dialysate flow rates theoretically may aid in reducing financial costs and improve water conservation efforts.