LAUSR

INTRODUCTION Reducing dialysate flow (Qd) to 400 mL/min has proven to be sufficient, safe, and effective in meeting dialysis adequacy requirements in adults, with the added advantage of decreasing water consumption per dialysis session. Expanded Hemodialysis [HDx], which uses dialyzers with membranes capable of enhanced clearance of medium-sized molecules due to expanded pore capacity, has higher efficiency and reduces the importance of the dialysate-to-blood flow ratio [Qd/Qb] for molecule removal. The objective of this study was to evaluate dialysis effectiveness by analyzing the reduction rate of medium-sized molecules in patients weighing ≤70 kg, comparing Qd 400 mL/min vs. 500 mL/min in HDx using Theranova® filter. METHODS AND RESULTS A sub-analysis of the COREXH study population was performed. This observational, analytical, retrospective cohort study included 23 patients, of whom 11 [47%] had Qd 400 mL/min and 12 [52.1%] had Qd 500 mL/min. No statistically significant differences were observed in the reduction rate of medium-sized molecules between the Qd 400 mL/min and 500 mL/min groups. Additionally, water consumption was lower in the Qd 400 mL/min group, with an average saving of 24 liters per patient per session and 13,824 liters over 12 weeks. CONCLUSION Using Qd 400 mL/min in HDx vs 500 mL/min did not affect dialysis effectiveness in terms of molecule reduction rates and resulted in substantial water savings in Qd 400 mL/min group.