{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T20:36:57Z","timestamp":1790800617942,"version":"4.1.0"},"reference-count":46,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2016,8,16]],"date-time":"2016-08-16T00:00:00Z","timestamp":1471305600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Seminars in Dialysis"],"published-print":{"date-parts":[[2016,11]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Mounting evidence supports a strong association between fluid management and outcomes among individuals receiving maintenance hemodialysis. The speed of fluid removal during dialysis (ultrafiltration, <jats:styled-content style=\"fixed-case\">UF<\/jats:styled-content>) is a modifiable aspect of fluid management that has attracted recent attention as a potential performance measure for facility fluid management practices. Observational data support an association between higher <jats:styled-content style=\"fixed-case\">UF<\/jats:styled-content> rates and adverse outcomes. This association is supported by the plausible pathophysiologic rationale of hypoperfusion\u2010induced ischemic injury to the heart and other end\u2010organs. However, no published clinical trial has studied the impact of lowering <jats:styled-content style=\"fixed-case\">UF<\/jats:styled-content> rates on clinical and patient\u2010centered outcomes. Lowering <jats:styled-content style=\"fixed-case\">UF<\/jats:styled-content> rates requires interdialytic weigh gain reduction and\/or extension of dialysis time. Weight gain reduction has proven difficult despite nutritional programs focused on salt and fluid restrictions, and patients are generally averse to longer treatment times. Thus, imposition of <jats:styled-content style=\"fixed-case\">UF<\/jats:styled-content> rate limitations may lead to failed target weight achievement and volume expansion over time. Despite these potential unintended consequences, the National Quality Forum endorsed an <jats:styled-content style=\"fixed-case\">UF<\/jats:styled-content> rate clinical performance measure in 2015. Prior to implementation of quality measure\u2010imposed <jats:styled-content style=\"fixed-case\">UF<\/jats:styled-content> rate limitations, prospective studies of <jats:styled-content style=\"fixed-case\">UF<\/jats:styled-content> rates and outcomes are needed.<\/jats:p>","DOI":"10.1111\/sdi.12529","type":"journal-article","created":{"date-parts":[[2016,8,16]],"date-time":"2016-08-16T10:48:40Z","timestamp":1471344520000},"page":"425-434","source":"Crossref","is-referenced-by-count":16,"title":["Ultrafiltration Rate Clinical Performance Measures: Ready for Primetime?"],"prefix":"10.1111","volume":"29","author":[{"given":"Jennifer E.","family":"Flythe","sequence":"first","affiliation":[{"name":"Department of Medicine Division of Nephrology and Hypertension UNC School of Medicine University of North Carolina Kidney Center Chapel Hill North Carolina"},{"name":"The Cecil G. 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