A year old article, but a very interesting take on the value of short daily dialysis versus longer dialysis times and prescription changes outside the NxStage guidelines. In this article Peter Laird MD discusses how he has managed to improve his spKt/V from 0.5 to over 0.9 by increasing the dialysate to 40L, the dialysate rate and also using a higher flow fraction of 45%. I use 30L, FF of 35% and I am seeing a spKt/V of 0.66 consistently – it would certainly be interesting to be able to try different prescription rates and measure the impacts on my blood results. Currently my PO4 is dropping (thankfully) but I will still keep my rate of binders up in the short term. Ultimately the proof will be in how I feel, as well as what the blood results say – that, after all, is what affects us all on dialysis. Pity those that abuse the in centre 3 day a week dialysis by not turning up, or doing shorter hours, don’t understand the impacts of their actions. Education!
Go here to read the full piece: http://www.billpeckham.com/from_the_sharp_end_of_the/2010/02/taking-nxstage-system-one-to-the-max.html a