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during hemodialysis fluid is removed from the patients blood along with toxins and then the blood is returned to the patient the process of removing fluids and toxins is called hemodialysis ultra filtration is slightly different its the removal of fluid only and how fast the fluid is removed is called the ultra filtration rate or au fr if fluid is removed too slowly there may not be enough time to remove the prescribed amount of fluid this can leave the patient fluid overloaded with problems like edema hypertension heart failure shortness of breath and fatigue if fluid is removed too quickly the patients blood volume can become depleted this can cause crashing symptoms like nausea cramping and vomiting in fact ultrafiltration rates above 13 milliliters per kilogram per hour can lead to hypotension myocardial stunning and hypervolemia due to the frequent turning down of the ufr or ending of treatments early because of intra dial it acceptance all of this leads to increased morbidity