I'm currently in the RN to MSN program and would like help on an assignment. My assignment is to Identify my nursing question to research. For example, a topic question could be: Does interdisciplinary teamwork affect patient outcomes? I would like some suggestions for a topic question related to nephrology nursing. Any suggestions? If you would like a topic researched, please post!!

Why home hemo programs are not utilized more in the USA?

You know what never made sense to me that I'd like to learn more about? Why is it that having a higher BFR and DFR will give you better clearances? When related to carbon tanks and chlorine removal, for example, the HIGHER the contact time, the BETTER. But it seems in dialysis, the LESS contact time, the better. Why is that?

GTSCSS,

As much as I would like to pretend being smart, it's actually very easy to explain.

In reference to DFR, the higher rate maintains a greater chemical gradient since fresh dialysate is entering the dialyzer faster so urea etc. do not get to as high of a concentration thus reducing the chemical gradient. From our own studies, we have found that by increasing the DFR by 60% from 500 to 800 only improves clearances by about 10%....not much bang for your buck in my book.

About BFR, urea is a very small molecule that permeates the membrane very easily and quickly so its clearance is more based on how much of it you can expose to the membrane rather than how long it is actually in contact with it.

I know that some Dr's think that DFR should be twice that of the BFR. In most cases this is not neccesary and only wastes valuable resources. You will achieve better clearances if you can raise the BFR 25-50 ml/min than you will by increasing the DFR with the added benefit that it does not cost a cent.

Chuck

quote:

Originally posted by Chuck W:
GTSCSS,

As much as I would like to pretend being smart, it's actually very easy to explain.

Chuck

So, your calling me a dummy??



Just kidding. Thanks for the insight. I never did get a clear explaination from questions I've posed in the past. But, now that you put it that way it does make sense. Thanks for the info!!