Fig. 2

Dosage adjustment protocol. The initial dosage is 6 l/day; then the solute clearance, water removal, and clinical manifestation are evaluated. If Kt/V < 1.7, dosage should be increased. If there is a volume overload, salt and water intake, diuretics, and dextrose concentration should be modified before changing dosage. When the dosage is ≥ 12 l/day and Kt/V < 1.7, the treatment adaptation fails. Physicians should be flexible in choosing optimal therapies to protect patients from life-threatening circumstances. The Kt/V and creatinine clearance rate should be re-evaluated 2 weeks after each patient’s situation stabilizes