Supplementary Material for: Differential Molecular Modeling Predictions of Mid and Conventional Dialysate Flows

<b><i>Background:</i></b> High dialysate flow rates (Q_D) of 500–800 mL/min are used to maximize urea removal during conventional hemodialysis. There are few data describing hemodialysis with use of mid-rate Q_D (300 mL/min). <b><i>Methods:</i></b> We constructed uremic solute (urea, beta₂-microglobulin and phosphate) kinetic models at varying volumes of distribution and blood flow rates to predict solute clearances at Q_D of 300 and 500 mL/min. <b><i>Results:</i></b> Across a range of volumes of distribution a Q_D of 300 mL/min generally yields a predicted urea spKt/V greater than 1.2 during typical treatment times with a small difference in urea spKt/V between a Q_D of 300 and 500 mL/min. A larger urea KoA dialyzer and 15 min of additional time narrows the urea spKt/V difference. No substantial differences were observed regarding the kinetics of beta₂-microglobulin and phosphate for Q_D of 300 vs. 500 mL/min. <b><i>Conclusion:</i></b> A Q_D of 300 mL/min can achieve urea clearance targets. Hemodialysis systems using mid-rate Q_D can be expected to provide adequate hemodialysis, as currently defined.