Learn how to get the most out of ultrafiltration during hemodialysis and peritoneal dialysis.
Ultrafiltration is a critical component of dialysis, helping people with kidney disease remove excess fluid from their bodies. Since kidneys naturally filter and regulate fluid balance, dialysis replicates this function when your kidneys can no longer do it effectively. The process is essential for maintaining fluid balance and preventing complications like swelling, high blood pressure, and heart strain. Learn about ultrafiltration, why it’s important, and how you can optimize the process during dialysis.*
Hemodialysis removes fluid using a dialysis membrane that acts as a semipermeable barrier. The process relies on pressure differences between your blood and the dialysate, a fluid used in dialysis. The fluid naturally moves from an area of higher pressure (the blood) to an area of lower pressure (the dialysate), reducing excess fluid.
The ultrafiltration rate (UFR) determines how quickly fluid is removed. Dialysis staff set this rate based on your fluid weight gain since your last treatment. If too much fluid accumulates between treatments, removing it too quickly can lead to:
In such cases, a longer or additional dialysis session may be required to remove excess fluid safely.
Tips for effective ultrafiltration in hemodialysis include:
Peritoneal dialysis (PD) uses the peritoneal membrane inside the abdomen to filter fluid and waste. The dialysate for PD contains dextrose (a type of sugar), which helps draw fluid from the blood into your peritoneal cavity. The amount of dextrose in the solution determines how much fluid is removed.
PD solutions are available in different dextrose concentrations (1.5%, 2.5%, and 4.25%), and clinicians adjust the strength based on your target weight. Higher concentrations remove more fluid, but too much high-dextrose use can cause inflammation and long-term damage to the peritoneal membrane.
Some best practices for effective ultrafiltration in PD are:
Ultrafiltration failure occurs when insufficient fluid crosses the peritoneal or dialysis membrane. Several factors can contribute to this issue, including:
To prevent ultrafiltration failure:
By understanding and managing ultrafiltration, patients undergoing dialysis can achieve better health outcomes and maintain a stable fluid balance, reducing complications and improving overall well-being.
*National Kidney Foundation. (n.d.). Ultrafiltration. https://www.kidney.org/kidney-topics/ultrafiltration
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