I have seen patiens with 10-15 kilo's on, and no this is not compliant! And sometimes patients are not compliant with their meds also, or their diet, or their dialysis regimen, or their mouths for that matter, just no compliance ability.
But please remember that these people too are patients and that we are there to serve them, and sometimes this tests every limit known to us...but in the end the one they are killing is themselves-slowly but surely. It is their crdiovascular system expanding, their tissue drowing, there lungs losing capacity due to excess fluids in them, their heart pumping more and more, harder and harder...and in time no more.
I sometimes want ot just make them aware, or scream back, or just jsut....but remember you are the one in charge and if you feel it is unsafe you have the right to refuse...but do not refuse cause your angry, and don't let anger get you to do something you'll regret....take a breathe, ask for help, and remember your a good person and so are they....God created us all and he doesn't make junk!
We used 3L/hr UF, as usually BP stays up with Ultrafiltration. Try starting them in Trendelnberg, maybe that will be enough. Try education of the physician so that trying different Sodium Programs along with UF programs to pull the weight off normally. Try using patient advocate groups to talk to the patient. Whatever, keep your coll! Good Luck!