Does Higher Dialysis Pump Speed Damage A Chronic Kidney Disease Patient's AV Fistula?

A viewer wrote to ask, " Why am I so tired after Dialysis? I am frequently out of breath and my AV Fistula arm hurts terribly! I cannot go on like this? Am I running my Dialysis machine too fast?"

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Dialysis pump speed is quite simply the speed at which a patient's Dialysis machine draws blood from their Arterial Line, puts it through the Dialysis Machine and then returns it into their body through the Venous Line. For most, Dialysis Treatments are a tradeoff between pump speed and amount of time on Dialysis. Typically, if a Chronic Kidney Disease patient slows down his/her pump speed, it means that s/he will have to increase Dialysis time to get an effective cleaning.  

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For most patients the idea of extending their Dialysis treatment is out of the question. In fact according to a recent, American Society of Nephrology study, 66% of patients would not be willing to extend their treatments for just 15 minutes even if that meant a less restricted diet. Hence, the questions then are, "What is a good pump speed? And can a patient pump too fast and damage their AV Fistula or maybe their hearts?" 

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According to 17 year Dialysis patient, Greg Collette (Big D and Me blog), "Put simply, within limits the faster the pump speed the better." Obviously, a faster blood pump speed increases the volume of blood cleaned and more toxins are removed from a Chronic Kidney Disease patient's body. However, others have noted studies which suggest that blood pump speed of 400 to 600 milliliters per minute is not okay. 

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 Studies such as the one published in the Journal of Vascular Access have noted that observed turbulence of needles due to higher pump speeds may cause damage to the walls of a patient's AV Fistula. However, the long time Dialysis patient, Mr. Collette insisted, "Two things that affect blood pump speed: the state of our fistula and needle size." 

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Greg Collette continued to suggest that if a Chronic Kidney Disease patient's Dialysis AV Fistula is "robust and stable and blood is flowing freely with no blockages" s/he is likely a candidate for a high pump speed, if it is cleared with his/her Nephrologist. Wellsphere (Health Knowledge Made Personal) agreed with Mr. Collette and stated, "So, as someone on Dialysis, it is in our interest to have the highest blood pump speed that our body and vascular access can tolerate."

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Needle size may make the difference, however. While most Dialysis patients are started with the 17 gauge needle and a pump speed of up to 250 milliliters per minute, as a Chronic Kidney Disease patient's AV Fistula matures the needle gauge should gradually increase with pump speeds. 

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The Big D and Me blog volunteered that with pump speeds of 300 to 350 milliliters per minute, Dialysis patients should use 15 gauge needles (the smaller the gauge the bigger the needle). Similarly, for pump speeds above approximately 360 milliliters per minute, patients should consider 14 gauge needles to avoid harmful side effects from their treatments. 

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Moreover, Chronic Kidney Disease patients who conduct Dialysis should realize that this is "true only for conventional In-Center Dialysis who come twice or thrice a week. For those on daily Dialysis, the pump speed can be lower to give a more gentle Dialysis," according to Wellsphere. 

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Thus, if you are not feeling well even after your Dialysis Treatments, discuss with your Nephrologists about increasing your Dialysis pump speed, or even transitioning to Home Hemodialysis to improve your clearance (blood cleaning) without extending your time In-Center. Also, for the latest breaking news and information about how those with Chronic Kidney Disease can better manage and improve their lives, visit every day, and Like us on Facebook so you do not miss a thing! 

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