UF Rate Calculation Threshold — ESENeph MCQ

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ModerateHaemodialysisUF Rate Calculation ThresholdESENeph

A 50-year-old man on haemodialysis has a target dry weight of 75 kg. During a dialysis session, the nurse sets ultrafiltration to remove 4 kg. The session is 4 hours. What is the UF rate per kg per hour and does it exceed recommendations?

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Correct answer: B — UF rate is 4000 mL / (75 kg x 4 hr) = 13.3 mL/kg/hr – this exceeds the KDOQI recommendation of <13 mL/kg/hr and increases hypotension and cardiac stunning risk; either reduce interdialytic weight gain or extend session time

High ultrafiltration rates (>13 mL/kg/hr per KDOQI, some guidelines use >10 mL/kg/hr) are associated with intradialytic hypotension, myocardial stunning (segmental wall motion abnormalities on echo during dialysis), and increased mortality. At 13.3 mL/kg/hr, this patient's UF rate marginally exceeds recommendations. Solutions include: reducing interdialytic weight gain (dietary sodium restriction), extending session time (4 to 4.5-5 hours), or adding an extra session. The HEMO and FHN trials showed that longer/more frequent sessions improve outcomes partly through lower UF rates.

Reference: KDOQI 2015 – HD Adequacy; Flythe et al 2011 – UF Rate and Mortality