Ultrafiltration Rate Thresholds in Maintenance Hemodialysis

An NKF-KDOQI Controversies Report

Holly Kramer, Jerry Yee, Daniel E. Weiner, Vinod Bansal, Michael J Choi, Laura Brereton, Jeffrey S. Berns, Milagros Samaniego-Picota, Paul Scheel, Michael Rocco

Research output: Contribution to journalArticle

Abstract

High hemodialysis ultrafiltration rate (UFR) is increasingly recognized as an important and modifiable risk factor for mortality among patients receiving maintenance hemodialysis. Recently, the Kidney Care Quality Alliance (KCQA) developed a UFR measure to assess dialysis unit care quality. The UFR measure was defined as UFR. ≥. 13. mL/kg/h for patients with dialysis session length less than 240 minutes and was endorsed by the National Quality Forum as a quality measure in December 2015. Despite this, implementation of a UFR threshold remains controversial. In this NKF-KDOQI (National Kidney Foundation-Kidney Disease Outcomes Quality Initiative) Controversies Report, we discuss the concept of the UFR, which is governed by patients' interdialytic weight gain, body weight, and dialysis treatment time. We also examine the potential benefits and pitfalls of adopting a UFR threshold as a clinical performance measure and outline several aspects of UFR thresholds that require further research.

Original languageEnglish (US)
JournalAmerican Journal of Kidney Diseases
DOIs
StateAccepted/In press - Feb 8 2016

Fingerprint

Ultrafiltration
Kidney Diseases
Renal Dialysis
Maintenance
Kidney
Dialysis
Quality of Health Care
Weight Gain
Body Weight
Mortality
Research

Keywords

  • Controversies
  • Dialysis
  • Dialysis dose
  • End-stage renal disease (ESRD)
  • Fluid removal
  • Hemodialysis (HD)
  • Interdialytic weight gain (IDW)
  • NKF-KDOQI
  • Performance measure
  • Quality of care
  • Sodium
  • Treatment time
  • Ultrafiltration rate (UFR)
  • Volume management

ASJC Scopus subject areas

  • Nephrology

Cite this

Kramer, H., Yee, J., Weiner, D. E., Bansal, V., Choi, M. J., Brereton, L., ... Rocco, M. (Accepted/In press). Ultrafiltration Rate Thresholds in Maintenance Hemodialysis: An NKF-KDOQI Controversies Report. American Journal of Kidney Diseases. https://doi.org/10.1053/j.ajkd.2016.06.010

Ultrafiltration Rate Thresholds in Maintenance Hemodialysis : An NKF-KDOQI Controversies Report. / Kramer, Holly; Yee, Jerry; Weiner, Daniel E.; Bansal, Vinod; Choi, Michael J; Brereton, Laura; Berns, Jeffrey S.; Samaniego-Picota, Milagros; Scheel, Paul; Rocco, Michael.

In: American Journal of Kidney Diseases, 08.02.2016.

Research output: Contribution to journalArticle

Kramer, H, Yee, J, Weiner, DE, Bansal, V, Choi, MJ, Brereton, L, Berns, JS, Samaniego-Picota, M, Scheel, P & Rocco, M 2016, 'Ultrafiltration Rate Thresholds in Maintenance Hemodialysis: An NKF-KDOQI Controversies Report', American Journal of Kidney Diseases. https://doi.org/10.1053/j.ajkd.2016.06.010
Kramer, Holly ; Yee, Jerry ; Weiner, Daniel E. ; Bansal, Vinod ; Choi, Michael J ; Brereton, Laura ; Berns, Jeffrey S. ; Samaniego-Picota, Milagros ; Scheel, Paul ; Rocco, Michael. / Ultrafiltration Rate Thresholds in Maintenance Hemodialysis : An NKF-KDOQI Controversies Report. In: American Journal of Kidney Diseases. 2016.
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