Transitioning from Isolated Ultrafiltration to Hemodialysis
I apologize, but the evidence provided does not address the specific procedural question of how to order or transition from isolated ultrafiltration (Iso UF) to hemodialysis (HD) in a provider's order set. The available guidelines focus on different clinical scenarios:
What the Evidence Actually Addresses
Switching Between Dialysis Modalities:
- The NKF-K/DOQI guidelines discuss transitioning from peritoneal dialysis to hemodialysis, not from isolated UF to HD 1
- Indications for PD-to-HD transition include failure to achieve target Kt/V, inadequate fluid removal, frequent peritonitis, or technical problems 1
Ultrafiltration Management During HD:
- Guidelines address ultrafiltration rate management during standard hemodialysis sessions, not transitioning between modalities 1
- UF rates should be individualized based on hemodynamic tolerance, with rates as low as 6 ml/h per kg associated with higher mortality risk 1
- Lowering UF rates can be accomplished by increasing HD time and/or decreasing interdialytic weight gain 1
Hybrid Therapy Approaches:
- In hyperammonemia management, HD can be initiated first for rapid clearance, then transitioned to continuous kidney replacement therapy (CKRT) to prevent rebound 1
- This represents HD-to-CKRT transition, not Iso UF-to-HD 1
Clinical Context Gap
The question appears to ask about procedural ordering (how to write orders for transitioning modalities), but the evidence addresses clinical indications for modality changes. Without institution-specific order set documentation or protocols for isolated ultrafiltration procedures, I cannot provide the specific ordering instructions requested.