Can someone clearly describe the sodium modeling and UF profiling programs on the FR2008H?

I would encourage you to look at the Blood Volume Monitoring Site.

Na Variance:
#1 - must have an MD order.
#2 - Always start with the lowest sodium and work upwards. Normal blood sodium levels are somewhere around 135-145. A good place to start, with physician approval, is around 145 and slowly work upwards to find the most minimal amount of sodium necessary.

#3 - sodium has a high cost for the patient. It will cause them to be thirsty, very thirsty, for about 4-8 hours after treatment, if too much is used. How much is too much? Depends on patient chemistry. Start low and move upwards. Patients must help decide what they would rather have: symptoms of hypovolemia (which can lead to access loss, feeling bad, etc) or increased thirst (which can cause fluid overloading). I've heard some patients state they will drink most of their fluid in the first 6 hours after treatment 'because I'm just so thirsty.' That's when it's time to modify the sodium settings to shut off earlier or decrease the amount of sodium.

#4 - The higher sodium concentration (conductivity) raises sodium in the intravascular compartment. This holds fluid in the blood stream longer, which assists in preventing both hypotension and cramping. The high blood sodium also pulls fluid from the interstitial spaces and prevents fluid in the vascular space from shifting into tissues where concentration of urea and other wastes may be high and exerting an osmotic pull.

#5 - Sodium is indicated for ease of fluid removal and reduce cramping, raise blood pressure, combat disequilibriuim, and increase sodium in hyponatremic patients.

#6 - Sodium is contraindicated in patients with hypertension.
#7 - Step Program - when the desired sodium increase is programmed the sodium will "step" up to that level and remain at that level for the programmed length of time chosen by the operator. You should program for a length of time 1/2 hour (30 minutes) short of the length of treatment so the sodium level can "step" back down to baseline conductivity for the last 1/2 hour (30 minutes). The idea is that the patient will hopefully leave treament with little overload of sodium.
Step is indicated for low BP during dialysis, cramping, disequilibrium syndrome and hyponatremia. Contraindicated for increased BP or hypernatremia

#8 - Linear Program - the sodium concentration will rise and evenly decrease over the duration of the treatment time programmed in. The entire length of a treatment should be programmed in. If this is used to treat cramping, the initial sodium level should be high enough so that mid-treatment sodium will remain high enough to treat cramping (5 meq above base).
Indicated for cramping and disequilibrium syndrome. Contraindicated for hypernatremia.

#9 - Exponential program - When the desired sodium increase is programmed, sodium concentration will increase and start decreasing to baseline after the first 45 minutes to 1 hour. Entire length of dialysis treatment should be programmed in.
Indicated for disequilibrium syndrome. Contraindicated for hypernatremia.

regarding UF Profile: ultrafiltration is the removing of liquid from your body using pressures. A UF profile of 1.0 would mean an even pulling of liquid across the entire treatment. A UF of 1.5 would be removing all the liquid (1.0) set for that treatment PLUS 50% more.
Lets say a patient cramps or low bp during last half of treatment consistently. Then perhaps removing more of the liquid during the first portion of treatment would be beneficial. Hence, we could 'profile' the ultrafiltration to match the ability of the patients body to tolerate 'the pull.' The settings on most fresenius machines are UF #'s one through four, with each offering a different idea of how to 'pull' (remove) the liquid from the body. Most physicians are agreeable to writing an order that states something like "may use UF profile prn." This type of order will give the staff enough room to change the profile, working closely with the patient to determine which is best for them.

Dear Kraftsims,
Glad you have returned and have provided technical info. to my question. I have been waiting all a long time for someone to explain this. I will be studying your post and will respond this weekend when I have time.

I recently got to try both a sodium and a Uf program. First, I tried a 145 linear sodium program ending at 140 30 min prior to the end of tx. It went fairly well. It was not at all the major improvement I had hoped it might be. The tx was a little gentler at times. I had thought it would keep my bps up at the end of tx, but it did not do this for me. One good thing, I did not experience any increased thirst with trying the program. But later that night, I experienced some insomnia. Not real bad, but enough to disturb my sleep.

Later in the week I tried a 2/3 UF program without sodium modeling..just my regular straight 140. Again, the tx was a little gentler in ways. It helped with restless leg which I usually experience moderatley at the end of tx. Totally stopped it. But the tradeoff was more tension at the beginning hours of the tx. when the UF was higher. And also, I had some insomnia that night.

It seemed that neither program made my tx better overall. Any suggestions on where to go from here?