How much part A , part B and water used in one session of HD ao in 4hr hrs
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hemodialysis part A part B concentrate water volume used per 4 hour session liters
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Now I have enough to give a comprehensive, calculated answer. Here is the breakdown:
HD Consumables Per 4-Hour Session
How Dialysate is Made
Modern hemodialysis machines mix three streams in a fixed ratio to produce dialysate:
| Component | Also Called | Contains |
|---|---|---|
| Part A (Acid concentrate) | Acid bath | NaCl, KCl, CaCl₂, MgCl₂, glucose, acetic/citric acid |
| Part B (Base concentrate) | Bicarbonate bath | NaHCO₃ + NaCl |
| Purified water | RO water | Reverse-osmosis treated water |
The standard mixing ratio is 1 : 1.72 : 42.28 (Part A : Part B : water) — this is the "45×" preparation, meaning the concentrates are diluted ~45-fold.
— Comprehensive Clinical Nephrology, 7th Ed.
Volume Calculations for a 4-Hour Session
Standard dialysate flow rate: 500 mL/min (range 500–800 mL/min)
Total dialysate produced in 4 hours:
500 mL/min × 240 min = 120,000 mL = 120 litres
Using the 45× ratio (1 : 1.72 : 42.28, summing to 45):
| Component | Fraction | Volume per 4-hr session |
|---|---|---|
| Part A (acid concentrate) | 1/45 | ~2.67 litres |
| Part B (bicarbonate concentrate) | 1.72/45 | ~4.58 litres |
| Purified water | 42.28/45 | ~112.75 litres |
| Total dialysate | — | ~120 litres |
Liquid vs. Powder Concentrates
- Liquid concentrates (most common): Part A typically supplied in 5 L or 10 L jugs; Part B in 10 L containers — so roughly one 5 L Part A jug and about half a 10 L Part B container are used per session.
- Powder/dry concentrates (Granuflo-type): Part A dissolved on-site; Part B is bicarbonate powder dissolved in water by the machine. Volume consumed is equivalent but delivered differently.
Key Notes
- At 800 mL/min dialysate flow (high-flux/intensified HD): total dialysate ≈ 192 litres, scaling concentrates proportionally (~4.3 L Part A, ~7.3 L Part B, ~180 L water).
- Water consumption per HD session (~120–200 L of RO water) is why water quality (ultrapure, endotoxin-free) is critical — contamination can directly affect the patient.
- The acid concentrate keeps pH < 7.3 to prevent Ca²⁺/Mg²⁺ precipitation when bicarbonate is added. — NKF Primer on Kidney Diseases, 8th Ed.
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