Increasing Dialysate Flow Rate over 500 ml/min for Reused High-Flux Dialyzers do not Increase Delivered Dialysis Dose: A Prospective Randomized Cross Over Study

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Wiparat Srisuwan
Saranya Charoensri
Kanittha Jantarakana
Thawee Chanchairujira


Objective: The primary objectives were: 1) to study the impact of Qd (500 vs 800 ml/min) on the delivered dose by reused dialyzers, and 2) to determine dialysis efficiency of a dialyzer reused 15 times.
Materials and Methods: A prospective randomized-controlled crossover study was conducted in 42 thrice-weekly hemodialysis (HD) patients (630 HD sessions in each Qd). Delivered doses at both Qds were assessed by single-pool Kt/V (spKt/V), equilibrated Kt/V (eKt/V) and online clearance monitoring Kt/V (Kt/VOCM), measured at mid-week HD session using a new dialyzer and then again at every mid-week HD session.
Results: Although the spKt/V in HD sessions using new dialyzers at Qd of 500 ml/min was slightly lower than spKt/V at Qd of 800 ml/min (2.19±0.08 vs. 2.34±0.08, respectively, P=0.04), when accounting for urea rebound as assessed by eKt/V and Kt/VOCM, there was no significant difference. The average delivered doses in dialyzers reused 15 times, with the mean average of spKt/V, eKt/V and Kt/VOCM at Qd 500 ml/min, were not significantly inferior to the delivered doses at Qd 800 ml/min. Reusing a dialyzer 15 times did not decrease dialysis efficiency and delivered doses in all HD sessions reached spKt/V >1.4.
Conclusion: Increasing Qd over 500 ml/min for modern dialyzers does not significantly increase delivered dose of dialysis. Dialyzer reuse does not affect dialysis efficiency and provides adequate dialysis therapy.


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Srisuwan, W. ., Charoensri, S. ., Jantarakana, K. ., & Chanchairujira, T. . (2022). Increasing Dialysate Flow Rate over 500 ml/min for Reused High-Flux Dialyzers do not Increase Delivered Dialysis Dose: A Prospective Randomized Cross Over Study. Siriraj Medical Journal, 74(3), 152–160.
Original Article


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