Effect of Dialysis Dose and Membrane Flux in Maintenance Hemodialysis

To the Editor: We are concerned about the conclusions of the report by Eknoyan et al. on the multimillion-dollar Hemodialysis (HEMO) Study (Dec. 19 issue) 1 that support the continued use of the current practice guidelines in the United States, which recommend a value of at least 1.2 for the single-pool Kt/V (where K represents the rate of urea clearance by the dialyzer in milliliters per minute, t the duration in minutes of the treatment session, and V the volume of distribution of urea in the patient in milliliters). There is now overwhelming evidence that such a dose is too low, . . .