By Bill Peckham
By email I received some polite push back on my post No. Two and half hours of dialysis three times a week is not enough. The corespondent related a case where a patient reported feeling better once their treatment length was shortened to 150 minutes, from 180. The larger point made by the email is that given that people are starting dialysis with higher GFRs, it is possible (likely?) that someone with significant urine output would do best by using short, infrequent treatments. Okay.
In my post I should have said: barring significant urine output anyone wondering if 3 hours (or two and a half hours!) of dialysis three times a week is enough dialysis should carefully read Dr. Agar's complete answer. But no, it isn't enough dialysis.
So if 180 minutes isn't typically enough dialysis, what do I think is enough dialysis?
During the Rogue River adventure there was a lot of talk about the provision of dialysis. On Wednesday night I sat down to be video taped answering questions about my dialysis world views. Here I talk about dose of dialysis:
It ends a bit abruptly, I'm still developing on my video editing skills.
I also wasn't able to embed clickable links at the end, so for the rest of the story checkout these nonprofit, independent, educational websites: Kidney School, Nocturnal Home Haemodialysis and Home Dialysis Central. You'll learn that with the proper dose, dialysis works well and you can live a life very similar to the one you were meant to live but for severe chronic kidney disease.
In summary, I would say the proper dose of dialysis is however much dialysis one needs to feel well and to normalize blood pressure.