Recent surveys of hemodialysis studies strongly support the fact that dialysis prescription is a modifiable risk factor. Six tracks to improve dialysis patient outcomes have been identified: change in vascular access option strategy and restricting catheter use; increasing time or frequency of dialysis sessions; assessment and management of fluid status; favoring removal of middle and large molecules by high-flux and convective clearance; considering ultrapurity of dialysis fluid purity as a new standard and a part of hemodialysis biocompatibility, and improving quality care and patient follow-up. By modifying dialysis prescription and by implementing a continuous quality assurance program it appears possible to improve dialysis patient survival.

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