Question

A patient arrives at the clinic for his routine dialysis. He weighs in at 108.0 kg.108.0 kg. After the patient’s last treatment, he weighed 105.6 kg.105.6 kg. His estimated dry weight (EDW) is 105.5 kg.105.5 kg. During the treatment, he will receive antibiotics intravenously with 150 mL150 mL of normal saline.

The excess fluid is removed from the patient by a process called ultrafiltration. The dialysis machine is programmed to calculate the ultrafiltration rate (UFR) based on the patient’s pre-weight in kilograms, goal volume, and the length of the treatment. If the patient is scheduled for a treatment time of four hours, what must the UFR be in milliliters per hour per kilogram of body weight (mL/h/kg) to reach the patient’s goal of 3000 mL?

UFR:

Answer 1

An UFR of greater than 13ml/kg/hr is the rate at which stunning has been identified. The key is to maintain a UFR <13ml/kg/hr to provide a safe ultrafiltration rate during treatment.  Adding Prime and Rinse back after the fact will then increase your UFR to greater than 13mg/kg/hr.

Your initial calculation is what will allow you to provide a safe treatment for the patient..

The formula used can be “Estimated Dry Weight X 13 X Treatment hours.” In the given case it would be as below,

Estimated dry weight 105.6kgs

Scheduled hours of treatment 4hours

Expected goal of UFR 3000mL ped day

UFR per hour/body wight 3000/(105.6 X 4) = 7.10mg/kg/hr