You use lower NHHD flow rates than we do why is this and arent high flow rates beneficial and necessary?
Your question says you use a blood flow rate (Qb) of 300 ml/min and dialysate flow rate (Qd) of 500 ml/min. We use an average Qb of 225-250 and a Qd of 300. The following reasons underpin our decision Initially in 1993-4, when Uldall and Pierratos began the first NHHD program in Toronto, they used a program of 8 hr dialysis/treatment, 6 x week and a Qd of 100 and Qb of +/- 250. When I visited in 1999 and decided to import his program to Australia, he only recently had increased the Qd from 100 to 200 and finally to 300. We chose to use 300 based on his experience at that time. Since then, others have used even higher rates – see below – but remember, our two programs (Toronto and Geelong) are based, in the main, on 6 treatments/week whereas many of the more recent ones are alternate nights (7/fortnight or 3.5/week). The less frequent the dialysis, the greater the need to up-regulate flows to compensate for the loss of time and to ensure adequate dialysis. So, what are the positives and
