The Effect of Increasing Surface Area of Dialyzer Membrane on Adequacy of Hemodialysis

Introduction: The patients with end stage renal disease requires 12 hours of hemodialysis per week divided in three equal sessions (4 hours/day for 3 days/week). Some studies show that adequacy of hemodialysis can be maintained by increasing the surface area of the dialyzer membrane and decreasing the frequency of treatment which can help the poor socioeconomic status patients in getting effective hemodialysis at a low cost. Objectives: To observe whether by increasing the surface area of dialyzer the dose of dialysis can be reduced against the standard hemodialysis prescription. Study design: Randomized Control Trial. Study Duration: Six months from March 2017 to August 2017. Settings: Department of Nephrology, The Indus Hospital Karachi. Subjects: ESRD patients undergoing Hemodialysis for at least 6 months at The Indus Hospital Karachi. Methods: In this prospective randomized control study, a total of 60 patients of end stage renal disease receiving hemodialysis for more than six months were included and divided into 2 groups randomly (Arm-A: twice weekly dialysis using a larger surface area dialyzer and Arm-:B thrice weekly dialysis using regular surface area dialyzer). Results: A total of 59 (30 in Arm A and 29 in Arm B) patients were enrolled in the study out of which majority of the patients were male (59.3%). On average significantly higher URR and eKt/V were reported in Arm A whereas, higher mean standard (weekly) stdKt/V was reported in Arm-B. Conclusion: Standard protocols should be followed to maintain the adequacy of Hemodialysis.