Hemodialysis intradialytic

A 3.5 h treatment of a 70 kg patient (V = 40.6 liters) with a urea clearance of 200 ml,/min should result in a 64% reduction in urea concentration or a value of 0.36 for the ratio d (f this parameter almost always falls between 0.30 and 0.45. The increase in urea concentration between hemodialysis treatments is obtained from equation 13, again assuming a constant V, where (f is the urea concentration in the patient s blood at the end of the hemodialysis, and d the concentration at time t during the intradialytic interval. 

Cruz DN, Mahnensmith RL, Perazella MA. Intradialytic hypotension is midodrine beneficial in symptomatic hemodialysis patients Am J Kidney Dis 1997 30 772-779. 

Twardowski, Z. J. High-dose intradialytic urokinase to restore the patency of permanent central vein hemodialysis catheters, Am. J. Kidney Dis., 1998 31(5) 841-847. 

Locking of the catheter with urokinase (5,000 lU instilled to each lumen for 30 min) maybe used to open occluded CVCs [37], but in some patients is ineffective and is suggested in those patients who have contraindications to systemic urokinase. High-dose intradialytic urokinase (250,000 lU infused into the venous chamber over 3 h) is safe and effective in almost all instances of nonpo-sitional malfunction of hemodialysis catheters without signs of sepsis contraindications to high-dose systemic urokinase are rare in stable hemodialysis outpatients [38]. However, it is not indicated in patients with recent trauma or surgery. 

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