Would you consider not returning the blood from the dialysis circuit as a strategy for managing polycythemia in a patient with ESKD on hemodialysis who has a hemoglobin level greater than 16 g/dL?

It has been a while since I had a patient on hemodialysis with polycythemia, but I have “wasted” the blood circuit so the patient wouldn’t have to go for phlebotomy on a non-dialysis day. I believe that we didn’t return the blood once a week until his hematocrit was at goal, and then as needed there...

I have not done that for polycythemia. I am not sure if I have even encountered that situation. Definitely, I have done that for patients with very high ferritin levels and those with iron overload.

I have not actually done this, but it makes perfect rationale sense.