One of the most important factors in the quality of your dialysis is the dialysis pump speed. This is the speed at which the dialysis machine draws blood from your arterial line, puts it through the dialyzer or the artificial kidney and then returns it to your body through the venous line.
The higher the blood pump speed, the better your blood gets cleaned by the artificial kidney. This is mainly because with higher pump speeds, more blood gets drawn and put through the artificial kidney which allows the artificial kidney to remove more and more toxins from the blood.
This is a picture of the blood pump from a Fresenius 4008S machine and the number '195' in the picture is the pump speed.
So, as someone on dialysis, it is in our interest to have the highest blood pump speed that our body and vascular access can tolerate and is required. Note that this is true only for people on conventional in-center dialysis who come twice or thrice a week. For those on daily dialysis, the pump speed can be lower to give a more gentle dialysis.
Many people complain that they do not feel 'good enough' on dialysis. This could be because they are not getting enough clearance or not enough toxins are being removed by dialysis. Ideally of course, the frequency of dialysis or the duration of the session must be increased. But if that is not possible, the next best alternative is to increase the blood pump speed. This will result in increased clearance and the person feels better.
Technicians and nurses sometimes do not risk high blood pump speeds because it can lead to some complications. However, they should gun for the highest pump speeds that the patient can tolerate. The pump speed must be gradually increased and if the patient does not complain of any problems and good flows are obtained (no air bubbles appear in the arterial line), then the pump speed is all right.
A word of caution though: every change in pump speed must be signed off by your nephrologist as every individual is different and may have different conditions (especially cardiac related) which may necessitate a different line of action.
But this is something definitely worth considering and talking about with your nephrologist and your technician or nurse.