Effect of lower dialysate flow rates on quality of life and metabolic parameters in hemodialysis

This study explored the efficacy of lower dialysate flow rates (Qd₃₀₀ mL/min) on quality of life (QoL) outcomes in end-stage renal disease (ESRD).

A prospective trial was conducted in participants receiving maintenance hemodialysis following a diagnosis of kidney failure who were currently stable with a dialysate flow rate ≥ 500 mL/min. Participants were transitioned to Qd₃₀₀ for 4 - 8 weeks and were assessed for clinical outcomes including the Edmonton Symptoms Assessment System (ESAS), Kidney Disease QoL (KDQoL-36), "time to recovery" (TTR), and an array of metabolic parameters, including measures of dialysis efficiency.

A total of 41 participants were enrolled with a mean dialysate flow rate of Qd₇₄₈. The majority of participants were male (65.8%) of Hispanic race (51.2%), had a mean age of 55.4 years (SD 11.5) with an average weight of 66.8 Kg (SD 12.39). Significantly improved KDQoL (3 of 5 components) was observed in participants transitioned to Qd₃₀₀ as well as a trend towards improved TTR and ESAS by 4 weeks (p < 0.05). Extension of Qd₃₀₀ for 8 weeks showed significant QoL improvements in 4 of 5 KDQoL components.

Modification of lower dialysate flow rates in participants receiving maintenance hemodialysis results in stable and improved KDQoL outcomes. Lower dialysate flow rates theoretically may aid in reducing financial costs and improve water conservation efforts.