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These side effects can be avoided and/or their severity lessened by limiting fluid intake between treatments or increasing the dose of dialysis e.g. dialyzing more often or longer per treatment than the standard three times a week, 3–4 hours per treatment schedule.
Home hemodialysis (HHD) is the provision of hemodialysis to purify the blood of a person whose kidneys are not working normally, in their own home. One advantage to doing dialysis at home is that it can be done more frequently and slowly, which reduces the "washed out" feeling and other symptoms caused by rapid ultrafiltration, and it can often be done at night, while the person is sleeping.
In the standard 3x/week hemodialysis schedule a URR of 65% is considered the minimum acceptable dose, corresponding to a minimum Kt/V of 1.2 [3] When dialysis is given more frequently than three times a week, the minimum acceptable URR is lower; because more dialysis treatments are given over the week, the dose of dialysis for each treatment ...
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Studies have demonstrated the clinical benefits of dialyzing 5 to 7 times a week, for 6 to 8 hours. This type of hemodialysis is usually called nocturnal daily hemodialysis and a study has shown it provides a significant improvement in both small and large molecular weight clearance and decreases the need for phosphate binders. [11]
There have been various alternative methods of measuring dialysis adequacy, most of which have proposed some number based on Kt/V and number of dialysis sessions per week, e.g., the standardized Kt/V, or simply number of dialysis sessions per week squared multiplied by the hours on dialysis per session; e.g. the hemodialysis product by Scribner ...
The equations are strongly dependent on session length; the numbers will change substantially between two sessions given at the same schedule, but with different session lengths. [citation needed] For the present plot, a session length of 0.4 Kt/V units per hour was assumed, with a minimum dialysis session length of 2.0 hours.
The majority of dialysis patients are on a 4-hour three times per week schedule. Indications for increasing dialysis session length or frequency include electrolyte and mineral abnormalities, such as hyperphosphatemia, hypercalcemia, and hyperparathyroidism, all of which are also risk factors for development of calciphylaxis. [1]