HEMODIALYSIS WITH LOW DIALYSATE FLOW-RATES - A COMPARISON OF HIGH-PERFORMANCE MEMBRANES AND CONVENTIONAL MEMBRANES

We performed experimental studies to examine the effects of low dialys ate flow rates on the clearance of small molecular weight substances, a middle molecular weight substance and a low molecular weight protein using a high performance membrane (HPM) and a conventional membrane ( CVM). The blood flow rate was 200 mL/min and the diasylate flow rate v aried between 300 and 500 mL/min. Clearance of urea and creatinine, re presenting small molecular weight substances, clearance of vitamin Bit representing a middle molecular weight substance, and clearance of my oglobin, representing a middle molecular weight substance, and clearan ce of myoglobin, representing a low molecular weight protein were meas ured. Lowering the dialysate flow rate from 500 to 300 mL/min in the H PM decreased the clearance of urea, creatinine, vitamin Bit and myoglo bin by 7.2%, 8.6%, 8.4%, and 2.4%, respectively. Lowering the dialysat e flow rate from 500 to 300 mL/min in the CVM decreased the clearance of urea, creatinine, and vitamin B-12 by 8.7%, 10.9%, and 10.4%, respe ctively. Changes in the clearance of creatinine with reduced dialysate flow rate in the HPM were significantly lower than those in the CVM ( P < 0.05). Clearance of urea, creatinine, and vitamin Bit in the HPM a t a dialysate flow rate of 300 mL/min were higher than those of in the CVM at a dialysate flow rate of 500 mL/min. These results suggest tha t dialysate flow rates can be reduced and water can be effectively sav ed by combining a dialysate flow rate of 300 mL/min with a HPM during water shortages due to natural disasters or climate changes.