One of my recent letters talked about options to in-center hemodialysis lasting about 4 hours. This message is for those of you continuing on this type of dialysis. I want to discuss the amount of time that you spend on dialysis.
We know that a minimum of 4 hours of on dialysis 3 times each week is needed to give yourself the best chance of remaining healthy. Patients who dialyze for 4 hours have about a 30% less chance of dying this year than patients who dialyze for less than 4 hours.
If you are dialyzing for less than 4 hours each time, I strongly recommend that you discuss with your doctor increasing your time to at least 4 hours.
Why do we recommend more than 4 hours for some patients? There are 2 main reasons. One is that we can only safely take off a certain amount of fluid each hour of dialysis. Some patients need longer time to get off all the fluids they drink. Other patients need more time because their blood tests show they do not get enough cleaning of the blood in 4 hours. The main blood test is called Kt/V and it measures the amount of cleaning of your blood you got in that dialysis treatment only. It is not a measurement of all the treatments in the month. It should be always above 1.2 for every treatment. We only check it once each month but you need to get at least that amount of dialysis every treatment.
Please understand that cutting short your dialysis by leaving before your dialysis is finished on days other than the day you have your blood drawn leads to you being less healthy. Missing dialysis treatments completely is even worse and strongly impacts your health.
Please address any questions that you have to the doctor who you see during dialysis.