A Rational Approach To Dialysis Time And Frequency

This blog post was made by Dr. John Agar, Home Dialysis Central


Good dialysis depends on the combination of both:

  1. Optimal frequency: to permit small and large solute removal.
  2. Optimal time: to allow slow, perfusion-friendly rate of volume removal.

The current Kt/Vurea formula has unfortunately encouraged clinicians to increase one of the two numerator variables (K) in an effort to reduce the other (t). This has resulted in the human body being treated like a multiplication table, where increasing one variable and reducing the other yields an unaltered result. Both 2 x 4 and 4 x 2 = 8.

Short Hours, Low Frequency Dialysis

This is the current majority reference point for most dialysis patients, and is how current “conventional” dialysis can best be described. Even conventional dialysis—as the term is loosely used in the dialysis literature—is not a single entity:

  • In the US, it is commonly 3.0 – 3.5 hours, 3 times a week.
  • In Japan and ANZ, it is more commonly 4.5 – 5.0 hours, 3 times a week.

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