treatment length

[George Jung]

Can HD treatment times be adjusted?  I am not having more than 2.5 kilos taken off and my labs have been consistently on the mark.  What would cutting back to 3.5 or 3 hrs from currently doing 4 hours?

[Rose From OZ]

Well from my experience, and from talking to numerous nurses and doctors, the truth is the more dialysis you do the better. In a "healthy" person your kidneys work 24 / 7!! so the more dialysis you can handle the better it is for you, as long as you monitor your potassium and stuff like......... so i wouldn't recommend cutting down your hours.
 
Rose.....

[del]

I agree with Rose - the more the better.  Even cutting back 1 mins can make a difference to your labs.  Studies show long and slow dialysis is the best.  That's why nocturnal is so good.

[George Jung]

I wasn't sure if the same results could be achieved with less time, but it seems the answer is NO.  Ty

[okarol]

Just found this at the
National Kidney and Urologic Diseases Clearinghouse http://kidney.niddk.nih.gov/kudiseases/pubs/hemodialysis/

Tests to See How Well Your Dialysis Is Working

About once a month, your dialysis care team will test your blood by using one of two formulas—URR or Kt/V—to see whether your treatments are removing enough wastes. Both tests look at one specific waste product, called blood urea nitrogen (BUN), as an indicator for the overall level of waste products in your system. For more information about these measurements, see the NIDDK fact sheet Hemodialysis Dose and Adequacy. http://kidney.niddk.nih.gov/kudiseases/pubs/hemodialysisdose/

[BigSky]

Can HD treatment times be adjusted?  I am not having more than 2.5 kilos taken off and my labs have been consistently on the mark.  What would cutting back to 3.5 or 3 hrs from currently doing 4 hours?

Time can be adjusted.  It all depends on lab work and size of kidney being used and dialysate flow rate, blood pump speed.  One can get away with having a good Kt/V and URR rate with less time.  However there is more to it than just good labs and Kt/V.

There is a side benefit to longer dialysis times in the removal of middle molecules and so forth that isnt shown in labwork.  It would be to the benefit for longer run times to aid in the removal of these other things that are not routinely tested that can lead to health affects in long term dialysis patients.

[RichardMEL]

See it's not just about fluid removal.. that's a side function.. but the more cycles of getting your blood through means it's cleaned more so more rubbish is taken out.. so yeah longer sessions are better alas...

And I'm doing 5 hours!!! And yes, it sucks! I'd love 4 hours

[jbeany]

Ask if your center uses Kt/V or URR to measure your dialysis adequacy.  URR (Urea Reduction Ratio) is more common, I believe.  URR is checked by taking a blood sample both at the beginning and end of your dialysis session.  Do you ever see them fill a blood vial at the end of the run?  They use a formula to get a percent clearance.  It should be at least 65%.  If they have too many patients below that number, they get in trouble with Medicare.  If your URR is consistently high, your neph may start lowering your total run time.  My URR was 80% or higher thru the first few months, and my neph has begun to shorten my run time.  He takes it down by 6 minute increments.  I currently run 3 hrs, 48 minutes.  (Don't ask me why six is the magic number- something to do with how the machines are set, I think.)  My URR is still at 80%, so he may drop it further, but I'm not sure I want him to do it.  I figure my day is already shot when I go, so gaining an extra 6 minutes won't help me get anything done, and I'd rather be as healthy as possible.

[George Jung]

thanks jbeany, I will make some inquiries next time I go.  You have a good point about the day being shot, it is just the last half hour that I get really impatient sometimes.  I was thinking if I could go to 3.5 hrs, but now I don't really think it would be worth it even if I could.