Sequential Ultrafiltration

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Specializes in Nephrology-Dialysis/Surgery/Orthopaedics.

We have patients who come in way too much above their dry weights so they get scheduled for an extra treatment the next day.

The charge nurse would only do sequential UF to them for 2 hours for the extra treatment. Is this also the practice in other parts of the world?

Also, what's the rationale behind positioning the dialyzer with the venous port placed up when on SEQ UF?

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Specializes in Home hemo.

In my experience, a 2-3 hour sequential treatment is standard. I have never heard of inverting the dialyzer for these treatments.

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Specializes in Nephrology-Dialysis/Surgery/Orthopaedics.

yes, where I used to work we do sequential without inverting the dialyzer.

But where I'm working now they invert it and when I asked them why, their response was "because it's in the protocol."

***** does it mean they blindly follow the protocol without understanding it? There's always a rationale for procedures and that's what I want to know in this case.

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Specializes in Renal.

We do 3 hour runs on an extra tx.

Never have inverted the dialyzer so the venous end is up though.

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from what i understand (and i dont know if its the real reason- or the research behind it) we turned the venous side up b/c the bi carb and acid arent being used- you are just removing fluid- with the red side down (the side hat removes the fluid) it's easier to pull fluid- using gravity to help- hope this makes sense-

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Specializes in Nephrology.

We have run them with dialyzers both ways. The old lines we used were arterial up but with the new lines, the venous segment is short so we run all treatment venous up. I haven't noticed any difference with our UF runs.

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Specializes in dialysis.

I ran my first sequential tx. today for 3 hours. and set the pt for 6000ml. he ended up only pulling 5.2. d/t him cramping. i was shocked that he ran the whole tx with a ufr of 2.0. oh yea ive been doing dialysis for 9 months.i've been a nurse for 8 months.

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Specializes in Nephrology-Dialysis/Surgery/Orthopaedics.

Why is it contraindicated to do sequential to patients with hyperkalemia?

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Specializes in Nephrology.
Why is it contraindicated to do sequential to patients with hyperkalemia?
When you are doing sequential ultrafiltration you are only removing fluid. If a patient is hyperkalemic, they need the cleaning as well.
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Why is it contraindicated to do sequential to patients with hyperkalemia?

Hi Sir. If I may answer you. Sequential UF, we only remove excess fluid from the patient. It is not really a contraindication, but perhaps regular HD is much better. That person needs clearance also which is achieved by HD or HDF always.

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