1. Is my URR 65 percent or higher?

2. If my URR is below 65 percent, what must be done to increase it to 65 percent or more?

There are several possible steps that could be taken to increase your URR to this level:

• The most effective step is to increase your time on dialysis.

• Increase the size or change the type of dialyzer.

• Increase your blood and/or dialysate flow rate.

Don’t ask to decrease your dialysis time unless you can maintain a URR of 65 percent or more. Decreasing your dialysis time resulting in a URR below 65 percent may increase your risk of premature death.

3. Is my URR 65 percent or more on the last use of my reused dialyzer?

This is not normally known and therefore should be tested to assure your URR is 65 percent or higher throughout the use of your reused dialyzer. If the resulting URR is below 65 percent in the last use, the reused dialyzer should be discarded. You and your doctor should determine how many uses of the dialyzer are possible while maintaining a URR of 65 percent or higher on every use.

4. Is my serum albumin 3.8 g/dl or above?

Ideally, by most tests of albumin, it should be 4.0 or above. If it is below the normal standard, ask your doctor and renal dietitian how you can increase it. This usually requires eating more protein each day. If you are being adequately dialyzed you should have the appetite for it.