98%
921
2 minutes
20
High hemodialysis ultrafiltration rate (UFR) is increasingly recognized as an important and modifiable risk factor for mortality among patients receiving maintenance hemodialysis. Recently, the Kidney Care Quality Alliance (KCQA) developed a UFR measure to assess dialysis unit care quality. The UFR measure was defined as UFR≥13mL/kg/h for patients with dialysis session length less than 240 minutes and was endorsed by the National Quality Forum as a quality measure in December 2015. Despite this, implementation of a UFR threshold remains controversial. In this NKF-KDOQI (National Kidney Foundation-Kidney Disease Outcomes Quality Initiative) Controversies Report, we discuss the concept of the UFR, which is governed by patients' interdialytic weight gain, body weight, and dialysis treatment time. We also examine the potential benefits and pitfalls of adopting a UFR threshold as a clinical performance measure and outline several aspects of UFR thresholds that require further research.
Download full-text PDF |
Source |
---|---|
http://dx.doi.org/10.1053/j.ajkd.2016.06.010 | DOI Listing |
Ren Fail
December 2025
Division of Nephrology, Department of Internal Medicine, Bursa Uludag University Faculty of Medicine, Bursa, Turkey.
Peritoneal dialysis (PD) and hemodialysis (HD) are the two primary renal replacement therapies for patients with end-stage renal disease (ESRD). While PD is an effective and convenient modality, long-term use can lead to ultrafiltration failure, recurrent peritonitis, and progressive structural alterations in the peritoneal membrane, necessitating a transition to HD. In recent years, rather than a complete transition, the combined use of PD and HD has emerged as a viable alternative, offering potential advantages for selected patient populations.
View Article and Find Full Text PDFSemin Dial
September 2025
Department of Nephrology, Atal Bihari Vajpayee Institute of Medical Sciences and Dr. Ram Manohar Lohia Hospital, New Delhi, India.
Background: In hyponatremic patients, concurrent dialysate flow during hemodialysis may be an ideal option to mitigate complications such as osmotic demyelination syndrome (ODS).
Methods: Present randomized controlled trial enrolled dialysis-requiring chronic kidney disease (CKD) and acute kidney injury (AKI) patients with serum sodium levels < 125 mEq/L during January 2020 over 16 months. Hemodynamically unstable patients, as well as those with a history of seizures and neurological conditions, were excluded.
Int J Gen Med
August 2025
Department of Nursing, Shanghai Sixth People's Hospital, Shanghai, 200233, People's Republic of China.
Objective: To investigate the risk factors of hypotension during maintenance hemodialysis in patients with end-stage chronic glomerulonephritis.
Methods: A total of 129 patients with end-stage chronic glomerulonephritis on maintenance hemodialysis admitted to our hospital from March 2022 to May 2024 were retrospectively analyzed, and the relevant clinical data of the patients were recorded. Univariate and multivariate logistic regression analysis were performed on various factors that may affect the occurrence of hypotension in patients, and the nomogram model was constructed.
Math Biosci Eng
July 2025
Department of Mathematics, College of Health and Natural Sciences, Zayed University, Abu Dhabi United Arab Emirates.
This study introduces a novel multivariable optimal control framework for hemodialysis, which uniquely integrates five physiological states (blood urea concentration, fluid volume, blood pressure, electrolytes, and hemoglobin) with three clinically adjustable inputs (ultrafiltration rate, blood flow, and dialysate composition). By employing the limited-memory Broyden-Fletcher-Goldfarb-Shanno-B (L-BFGS-B) algorithm with patient-specific box constraints, the model enforces patient-specific physiological safety limits while dynamically balancing clinical targets. Numerical simulations demonstrate the stabilization of key parameters within ±5% of clinical benchmarks (e.
View Article and Find Full Text PDFBMC Nephrol
September 2025
Division of Nephrology, Department of Internal Medicine, Taipei Veterans General Hospital, No. 201, Sec. 2, Shih-Pai Road, Taipei, 11217, Taiwan.
Background: Encapsulating peritoneal sclerosis (EPS) can result in abdominal organ encasement, and bowel obstruction, and is associated with a high mortality rate. While various risk factors have been identified for the development of EPS, the factors influencing patient outcomes in EPS are less well-studied. This study aims to investigate the prognostic factors that affect the clinical course and survival of EPS patients.
View Article and Find Full Text PDF