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Strategies for SCD Prevention in HD Patients








         General Strategy                                                Specific Intervention




       Calcium shifts                      - Avoid low calcium (< 2.5 mEq/L) ,especially with


                                           concurrent use of QT interval prolonging medications



       Metabolic alkalosis - Avoid high dialysate bicarbonate concentrations in


                                           alkalotic patients



       Rapid ultrafiltration - Encourage patient adherence to salt and fluid restrictions


                                           - Avoid sodium ramping and large dialysate/serum sodium



                                           gradients


                                           - Extend dialysis time so that ultrafiltration rates do not


                                           exceed 10 ml/kg/hr







                                                                                                   Am J Kidney Dis. 2017;69(5):684-695.
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