title: Can a decreasing ultrafiltration profile affect the dialytic dose administered?
abstract: During hemodialysis, ultrafiltration (UF) seems to affect the dialytic dose because of convective removal of urea and contraction of its distribution volume. We aimed to assess whether the adoption of a decreasing UF profile could yield a different dialytic dose from that obtained with a constant UF mode. Ten patients were randomly assigned to undergo 12 sessions with a constant UF mode (phase A) followed by 12 sessions with a decreasing UF rate (phase B), or the reverse. Kt/V and urea reduction ratio (URR) were 1.77 +/- 0.26 and 70.02 +/- 8.26% in phase A vs. 1.81 +/- 0.36 and 71.02 +/- 6.48% in phase B, respectively, showing no significant difference. Measurement of the differences in volemic variations between the two phases showed a statistically significant difference at the second hour (P < 0.001, the volemic reduction being greater in phase B than A) and at the fourth hour (P < 0.001, being greater in phase A than B). In standard bicarbonate dialysis, the adoption of a decreasing UF profile rather than a constant one does not alter the efficiency of the dialytic treatment.
authors.affiliation: Section of Nephrology, Department of Internal and Public Medicine, University of Bari, Bari, Italy. a.ramunni@nephro.uniba.it
authors.forename: Alfonso
authors.initials: A
authors.lastname: Ramunni
authors.forename: Paola
authors.initials: P
authors.lastname: Brescia
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Ranieri
authors.forename: Roberto
authors.initials: R
authors.lastname: Ria
authors.forename: Pasquate
authors.initials: P
authors.lastname: Coratelli
mesh_terms: D000368:Aged; D001794:Blood Pressure; D001810:Blood Volume; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D006435:Renal Dialysis; D014462:Ultrafiltration