I have dialyzed people with functioning kidneys to remove certain poisons, such as antifreeze. You all are correct, we don't remove fluid. Also, the phosphorus, which is so hard for many dialysis patients to get down, can go dangerously low, so if it's a long dialysis, I will add phosphorus to the dialysate. And I have the pharmacy mix up a K4 bath so as not to depress the potassium. IV calcium might also be needed since standard dialysate is a little lower than normal blood values. But with those tweaks, it does what we need it to do.