Case 5: Dialysis Disequilibrium Syndrome

 Lets slow things down! A patient at risk of dialysis disequilibrium syndrome

58 year old Caucasian female with history of systemic lupus erythematosus, hypertension, stroke, alcoholic cirrhosis and chronic kidney stage 5 is being initiated on hemodialysis for worsening uremic symptoms (worsening nausea, vomiting and headaches over the past couple of months) via a left arm brachiocephalic AV fistula. Her predialysis laboratory data is as follows: BUN- 140mg/dl; creatinine- 8.0; Serum K- 5.2meq/l; serum bicarbonate-12meq/l. Serum Na-135meq/l.

Choose the best dialysis Rx for this patient for his first hemodialysis treatment.