Abstract
There are two factors in shortening the period of hemodialysis therapy: (1) the solute removal rate, and (2) the number of times of therapy in a week. The former is accomplished not only with higi-periormance dialyzers, but by using hypertonic dialysate for removing excess fluid from the body water. And for the latter, it is advantageous to remove solutes by increasing the frequency of the therapy during the same total therapeutic time each week.
It was possible to shorten the therapeutic time by using high-performance dialyzers. However, predialysis urea-N and creatinine concentration levels (PDC) gradually increased. And the psuedo solute generation rate of uric acid and phosphate also increased, though the PDC of those solutes was not so obviously changed. Considering the declining tendency of hematocrit, it was a little too difficult to perform the short-time dialysis relying exclusively on high-performance dialyzers.
We have also been able to make sure that the therapeutic schedule was closely related with the capability of the solute removal. That is to say, in patient whose therapeutic schedule was changed from twice a week (7.5hr/Rx) to three times a week (5.0hr/Rx), it was observed that a decreasing tendency was seen in the solute concentration level. We thus concluded that frequent treatment is superior to the conventional schedule and this method is effective for shortening the therapeutic time.
