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Electrolyte Management in Frequent Home Hemodialysis

Authors

  • Rhonda S. King,

    1. Section on Renal Disease and Hypertension, School of Medicine, Hospital of the University of Pennsylvania, University of Pennsylvania, Philadelphia, Pennsylvania
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  • Joel D. Glickman

    1. Section on Renal Disease and Hypertension, School of Medicine, Hospital of the University of Pennsylvania, University of Pennsylvania, Philadelphia, Pennsylvania
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Address correspondence to: Joel D. Glickman, MD, Section on Renal Disease and Hypertension, Hospital of the University of Pennsylvania, One Founders, 3400 Spruce Street, Philadelphia, PA 19104, Fax: 215-615-0349, or e-mail: joel.glickman@uphs.upenn.edu

Abstract

Short daily hemodialysis (SDHD) and nocturnal home hemodialysis are modalities performed at home at shorter intervals than conventional hemodialysis. Because of their increased frequency, these alternative modalities create the potential for less inter-dialytic fluid gains and therefore fewer episodes of intra-dialytic hypotension. By more closely replicating normal renal physiology, they may also improve electrolyte management. In this article, we review published data on levels of calcium, phosphate, potassium, and bicarbonate levels using these home dialysis modalities. We also present our single-center experience with electrolyte management in patients maintained on SDHD using low dialysate flow rate, a modality of growing prevalence.

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