One of the most important factors in the quality of your dialysis is the dialysis pump speed. This is the speed at which the dialysis machine draws blood from your arterial line, puts it through the dialyzer or the artificial kidney and then returns it to your body through the venous line.
The higher the blood pump speed, the better your blood gets cleaned by the artificial kidney. This is mainly because with higher pump speeds, more blood gets drawn and put through the artificial kidney which allows the artificial kidney to remove more and more toxins from the blood.
This is a picture of the blood pump from a Fresenius 4008S machine and the number '195' in the picture is the pump speed.
So, as someone on dialysis, it is in our interest to have the highest blood pump speed that our body and vascular access can tolerate and is required. Note that this is true only for people on conventional in-center dialysis who come twice or thrice a week. For those on daily dialysis, the pump speed can be lower to give a more gentle dialysis.
Many people complain that they do not feel 'good enough' on dialysis. This could be because they are not getting enough clearance or not enough toxins are being removed by dialysis. Ideally of course, the frequency of dialysis or the duration of the session must be increased. But if that is not possible, the next best alternative is to increase the blood pump speed. This will result in increased clearance and the person feels better.
Technicians and nurses sometimes do not risk high blood pump speeds because it can lead to some complications. However, they should gun for the highest pump speeds that the patient can tolerate. The pump speed must be gradually increased and if the patient does not complain of any problems and good flows are obtained (no air bubbles appear in the arterial line), then the pump speed is all right.
A word of caution though: every change in pump speed must be signed off by your nephrologist as every individual is different and may have different conditions (especially cardiac related) which may necessitate a different line of action.
But this is something definitely worth considering and talking about with your nephrologist and your technician or nurse.
The higher the blood pump speed, the better your blood gets cleaned by the artificial kidney. This is mainly because with higher pump speeds, more blood gets drawn and put through the artificial kidney which allows the artificial kidney to remove more and more toxins from the blood.
This is a picture of the blood pump from a Fresenius 4008S machine and the number '195' in the picture is the pump speed.
So, as someone on dialysis, it is in our interest to have the highest blood pump speed that our body and vascular access can tolerate and is required. Note that this is true only for people on conventional in-center dialysis who come twice or thrice a week. For those on daily dialysis, the pump speed can be lower to give a more gentle dialysis.
Many people complain that they do not feel 'good enough' on dialysis. This could be because they are not getting enough clearance or not enough toxins are being removed by dialysis. Ideally of course, the frequency of dialysis or the duration of the session must be increased. But if that is not possible, the next best alternative is to increase the blood pump speed. This will result in increased clearance and the person feels better.
Technicians and nurses sometimes do not risk high blood pump speeds because it can lead to some complications. However, they should gun for the highest pump speeds that the patient can tolerate. The pump speed must be gradually increased and if the patient does not complain of any problems and good flows are obtained (no air bubbles appear in the arterial line), then the pump speed is all right.
A word of caution though: every change in pump speed must be signed off by your nephrologist as every individual is different and may have different conditions (especially cardiac related) which may necessitate a different line of action.
But this is something definitely worth considering and talking about with your nephrologist and your technician or nurse.
Comments
I plan to start home dialysis soon, and hope to stay with this value. I feel quite sick when the speed exceeds 280 ml/min. I get a bad headache.
I would hesitate to give too much discretion to a Techie.
Kamal's post can be treated as a point for Nephros and Manufacturers to discuss on the recommended settings and speeds.
See, with what ever speed blood enters the dialyzer, it will have to find its way out only after the toxins are cleaned right? Then how is it that tolerable high speeds are recommended?
If my understanding is right, the machine may draw low quantity of blood or high quantity of blood per second(lets say this way), but still it will have to do its job of recirculating whole quantity of blood for cleaning the toxins. And the dialisis will last till the whole blood is cleaned up. My question is to just understand this better.
Thrinath, the way it works is - the blood is continuously pumped out from the body and passed through the artificial kidney. In one pass, however much can be removed is removed and the blood is pumped back into the body. The toxins are not all removed in one pass. The greater the number of passes, the better the toxin removal. And the number of passes totally depends on the pump speed.
And btw, no doubt is ever stupid Thrinath! I appreciate your attempt at trying to understand this better!
My husband speed is between 100 to 150 most of time , only once did it reach 170.
How bad or good ios this speed and what is teh next step , if this has to be improved
pls advise