CMS Guidelines for Fluid Management
In an effort to increase patient safety and improve patient outcomes, the Center for Medicare and Medicaid Services (CMS) released new guidelines for hemodialysis fluid management (CMS, 2016). Ultrafiltration is a measurement of how quickly fluid volume (mL) is removed per kilogram of body weight in an hour during your hemodialysis treatment. Research suggests that high ultrafiltration rates pose a significant risk to patient mortality and morbidity. The CMS rule suggests a maximum ultrafiltration rate (UFR) of 13 mL/kg/hr.
Pennsylvania Dialysis Clinic of Reading, Inc. and Reading Dialysis Center, LLC will implement this rule on June 1, 2018.
- The doctors and the staff will follow the Centers for Medicare and Medicaid Services guidelines for patient fluid removal during hemodialysis treatments (maximum UFR of 13 mL/kg/hr).
- Medicare and Medicaid control the dialysis clinic’s ability to remain open and to provide you with the dialysis treatments you need to live a healthy life.
- The government has determined that all dialysis clinics must follow the new fluid removal formula which is based on your weight and length of treatment.
- High fluid removal leads to increased rates of low blood pressure resulting in decreased blood flow to your heart causing potential heart damage and possible death.
How you can improve your health:
- Limit the amount of fluid you take in between treatments
- Measure the amount of fluid you plan to drink for the day
- Limit your salt intake
- Use hard candy or ice to help decrease the amount of fluid you are drinking
- Stay on the full length of your treatment -every minute of missed time adds up to extra fluid left in your body
- Report for your 3 treatments every week
Managing your fluid intake:
If too much fluid builds up in a dialysis patient’s body, they may develop the symptoms listed below. Some people do not feel any of these symptoms, but the large fluid gains can strain the heart. Fluid gains of 5% or more of your body weight increase your risk of heart damage and death.
Limiting your fluid intake will help you avoid these symptoms and decrease your risk of heart damage and death. It will also make you feel better when less fluid has to be removed from your body during your dialysis treatments.
Symptoms of Fluid Build-up:
- Shortness of breath
- High blood pressure
- Damage to your heart
- Swelling (especially around your legs and ankles)