Aboagye, A.2025-02-192021https://ugspace.ug.edu.gh/handle/123456789/42931MPhil. Biomedical EngineeringHemodialysis is associated with high morbidity and mortality due to inefficiency of dialysis. Dialysis adequacy is based on numerous factors, such as dialysate flow rate and dialyzer size. These parameters are normally adjusted per the patient's clinical needs in countries such as the United Kingdom and the United States of America. In the Ghanaian context, dialysate flow rate adjustment, dialyzer (filter) size selection, and the use of KT/V estimated by the dialysis machine (HD-KT/V), which are used to determine dialysis adequacy are not used in our hospitals. This study was therefore designed to assess the effect of High-flux Dialyzer size and Dialysate flow rate on Dialysis Adequacy in hemodialysis patients in Accra, Ghana. Twenty-five patients were considered for a Cross-Over Clinical Trial. The experiment was divided into four stages which comprised the pairing of dialysate flow rate (500 and 800 ml/min) and High-Flux dialyzer size (1.8 and 2.1 m2 ). Urea Reduction Ratio (URR) and KT/Vurea were calculated from the experimental data and HD-KT/V was recorded from the dialysis machine after the dialysis treatment. Paired sample t-test was used to assess the effect of each of the dialyzer sizes and dialysate flow rate on dialysis adequacy and a repeated ANOVA was used to assess the relationship between the experimental results and KT/V estimated from the dialysis machine. The effect of dialysate flow rate on dialysis adequacy was analysed and found out that 800 ml/min gave a better dialysis adequacy than 500 ml/min when both 1.8 m2 and 2.1 m2 were used. It was observed that for dialyzer with 2.1 m2 , KT/Vurea did not record dialysis inadequacy but observed a 38% increase from moderate adequacy to total dialysis adequacy; for URR, total dialysis adequacy was increased by 38.4%, and all the 53.8% who had dialysis inadequacy when dialyzed with 500 ml/min either achieved moderate or adequate dialysis. The effect of dialyzer size on dialysis adequacy was also analysed and the results indicates that 2.1 m2 gave a better dialysis adequacy than 1.8 m2 when a dialysate flow rate of 800 ml/min was used, however, 500 ml/min yielded no difference in the means. It was observed that for dialysate flow of 800 ml/min; none of the participants got dialysis inadequacy (KT/Vurea) and dialysis inadequacy for URR was reduced by 15.3%; total dialysis adequacy was therefore increased in both cases (URR, 30.7%; KT/Vurea, 23%). It was finally determined that HD-KT/V cannot be used to predict KT/Vurea values for 500 ml/min when 1.8 m2 and 2.1 m2 were used, but can be used to predict KT/Vurea values for 800 ml/min when both 1.8 and 2.1 m2 were used. The out-come and findings if adequately implemented in our hospitals may improve dialysis adequacy; thereby reducing mortality and morbidity in hemodialysis patientsenHemodialysisGhanaHigh-Flux Dialyzer SizeThesis