Maintenance haemodialysis with low dialysate flow rates in Senegal

Abstract

Introduction: The objective of the study reported here was to demonstrate that maintenance haemodialysis using a reduced dialysate flow rate of 300 mL/min (RQ_D) is not inferior to haemodialysis using the standard flow rate of 500 mL/min (SQ_D) in respect of the delivered dose of dialysis.

Methods: A prospective, single-centre, sequential study was performed at the haemodialysis  centre of Pikine Hospital in Dakar. Twenty patients were included. During the first week, three haemodialysis sessions were performed with SQ_D and during the second week three haemodialysis  sessions were conducted with RQ_D for each patient.

Results: For SQ_D, the mean eKt/V was 1.38 ± 0.58. There were 38 (63%) sessions with eKt/V greater than 1.2 and 16 patients (80%) had adequate dialysis, based on the average eKt/V. For RQ_D, the mean eKt/V was 1.2 ± 0.43 with 25 sessions (42%) having an eKt/V greater than 1.2. There were 11 patients (55%) with adequate dialysis. The dialysis dose was higher with the SQ_D prescription (P < 0.001). Ten patients with dry weight ≤60 kg had adequate dialysis with RQ_D. Cases of hypokalaemia were significantly higher with the SQ_D (P = 0.001).

Conclusions: RQ_D appears to be inferior in terms of dialysis dose. However, for patients with dry weight ≤60 kg, adequate dialysis could be delivered with RQ_D, consequently allowing substantial saving of water in haemodialysis.