Ultrafiltration and dialysate sodium profiling: choosing the optimal therapy for your patients

Impaired vascular refilling and declining plasma osmolality contribute to the incidence of complications during hemodialysis therapy. Interventions such as ultrafiltration and dialysate sodium profiling can be utilized to make dialysis treatments more effective and comfortable for patients. Selecting appropriate profiles requires careful clinical assessment and an understanding of the principles supporting these interventions. This paper describes fluid distribution and factors influencing vascular refilling during hemodialysis. The principles of ultrafiltration and dialysate sodium profiling are discussed and validated. Guidelines for clinical assessment and selection of profiles are presented.