Access Nephrology

A Commitment To Private Practice In Renal Medicine

MANAGING DIALYSIS

Dialysis Schedule

Assessing your own Dialysis

Dialysis Key Performance Indicators.
This scoring pad is sourced with permission from the Dialysis Key Performance Indicators developed by Prof John Agar.

The program below is an adaption, and tailored to our patients

Questions Dialysis Key Performance Indicators

 

The PATIENT

Points
1. Are you currently feeling “pretty good” about things? 1
2. Are your diet and fluid intake free of major restrictions? 1
3. Is your blood access a native arteriovenous fistula? 1
4. Is your dialysis free of cramp, nausea and headache? 1
5. Are you part or full time employed or retired by choice? 1
6. Have you remained out of hospital for the last three months? 1
7. The Dialysis

Seven or more dialysis sessions per two weeks?

1
8. Eighteen hours dialysis or greater per week? 1
9. kT/v greater or equal to 1.3? 1
10. Interdialyitic weight gain less or equal to 2L? 1
11. Pre-dialysis systolic blood pressure equal to or greater than 105 and less than or equal to 150? 1
12. No intra-dialytic saline in the last four weeks? 1
13. The Tests

Haemoglobin greater or equal to 110, less than or equal to 125?

1
14. Transferrin saturation greater than 20%, less than 45%? 1
15. Calcium phosphate product less than 4? 1
16. Calcium greater than 1.9, less than 2.6? 1
17. Parathyroid hormone greater than 14, less than 40? 1
18. Albumin greater or equal to 35? 1
19. C-reactive protein less than 5? 1
20. The Medications
No blood pressure medication required?
1
21. No phosphate binder required? 1

Good Dialysis 16-21
Should improve Dialysis 10-16
Poor dialysis less than 10

The medical view is the more the better!
Usually 12 hrs a week on Haemodialysis is a minimum.

BUT

There are some patients, whose lifestyle is such that they do not wish to maximise dialysis.

This is particularly so in the older age group, who find the burden of maximal dialysis incompatible in their view for why they are having it in the first place.

Thus dialysis schedules are frequently tailored to a patients requests, rather than a biochemical ideal.