How to determine the amount of fluid to remove during a hemodialysis session?
Typically, a patient will gain between 1% and 5% of their body weight from fluid accumulation between dialysis sessions.
Patients receiving chronic hemodialysis are assigned a dry weight by their nephrologist. A common definition of dry weight is the weight below which patients become hypotensive on dialysis.
A more precise physiologic definition of dry weight is the body weight at a physiologic extracellular volume state. Practically speaking, the dry weight is the weight at which the patient is euvolemic on a minimal number of blood pressure medications.
The dry weight is set based on clinical findings and by patient response to removing additional fluid.
The patient’s dry weight will vary over time as a result of changes in appetite, the presence of diarrhea, and the like; thus, the patient’s dry weight should be reassessed on a regular basis.
