I’ve been doing Peritoneal Dialysis for a week now and I still don’t really understand what is the ultra-filtration rate. Can anyone explain a little bit more? Also what numbers are considered to be good ultra-filtration rates? Any info would be great. Thanks!
“Ultrafiltration” is the removal of fluid during dialysis. With PD, how much fluid you remove during PD is affected by how much fluid you have in your body, the sugar content of the solution you use (1.5%, 2.5%, or 4.25%), how long the fluid stays in your peritoneal cavity (dwell time), and how fast fluid and wastes are transported from your blood through your the lining of your peritoneum into the dialysis solution.
With the removal there is removal of wastes. How good dialysis is working is measured initially during the first month and every 4 months after that. The goal is to have a Kt/V (dialysis adequacy value) of 1.7 or higher. You can read about dialysis adequacy in Module 10 of Kidney School at https://www.kidneyschool.org/mods/.
There is a test called the peritoneal equilibration test (PET) to determine how fast or slow your body transports fluid and wastes. From the results, your doctor can tell whether you can get enough dialysis using a cycler with short dwell times (high transporter), whether you can do either the cycler or manual exchanges (average transporter) or whether you need to do manual PD that uses longer dwell times (low transporter). You can read about the PET at https://www.homedialysis.org/life-at-home/articles/the-peritoneal-equilibration-test-for-pd.
Finally, the higher the sugar content in the dialysis solution and the faster the transport rate, the more fluid is removed. It’s important use the lowest sugar content solution most of the time and to not use 4.25% dialysate too often. Its higher sugar content can scar your peritoneal membrane which can make PD not work well enough to keep you healthy. To keep from having to use the higher sugar solution, follow recommendations for diet and fluid. Although with sticking to your fluid limit, limiting sodium in your diet can help you keep from retaining fluid.
I have been on PD 2 months and had a 1.5 after a month them in December had a 2.03 and got my CVC removed and have been normally on a 10 hr (5 Cycle) usuing most the 2.5 and 1.5 solutions…only use 2 2.5s when weight BP elevations increase. DO NOT use a 4.25 unless you are directed to do so. Also, my UF runs different a lot from 200 to 1200 per therapy. We always use the manual drain also even if UF is high to get more fluid out. Sometimes get a low drain alarm which is crazy…last night the first low drain lasted at least an hour which will screw up overall dwell times.