Mid-Range Dialysate Flow and Adequacy of Dialysis.

IF 2.2 3区医学 Q3 HEMATOLOGY

Blood Purification Pub Date : 2025-04-21 DOI:10.1159/000545703

Ami M Patel, Nazli Atefi, Jagman Chahal, Abutaleb Ahsan Ejaz

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引用次数: 0

Abstract

Introduction: The primary objective was to investigate the efficiency of a fully-integrated, hemodialysis machine that utilizes mid-range dialysate flow rate of 300 ml/min in the acute hospital setting.

Methods: We conducted a retrospective, single-center pilot study. All Veterans with end stage kidney disease (ESKD) or dialysis-dependent acute kidney injury (AKI), who completed > 3 hrs of hemodialysis and had predialysis blood urea nitrogen (BUN) > 20 mg/dL with available post-dialysis BUN from February 2023 to June 2023 were included. Urea reduction ratio (URR) and single-pool Kt/V were compared between groups with varying dialyzer sizes and duration of treatment.

Results: 59 dialysis sessions were included for analysis. Mean Kt/V and URR for the full cohort were 1.26+0.04 and 60.8+7.3%, respectively. The percentage of sessions achieving minimum adequate clearance per Kt/V and URR criteria were 50.6% and 32.5%, respectively. In the subgroup analysis of dialysis sessions of different filter size (OptifluxTM F160NR or F180NR dialyzers) and varying duration (3, 3.5, 4 hours), the percentage of sessions achieving minimum adequate Kt/V in the F160/3.5hr, F180/3.5hr and F180/4hr groups were 44%, 50% and 58.8%, respectively.

Conclusion: The restriction of QD to 300 ml/min may compromise adequacy of dialysis in acute care setting. This may be mitigated by prolonging session times, albeit at the expense of higher resource utilization, and improving the QD:QB ratio. Further studies in a larger hospital cohort are necessary to elucidate these issues. .

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中期透析液流量与透析充分性。

简介：主要目的是研究一种完全集成的血液透析机的效率，该透析机在急性医院环境中利用300 ml/min的中程透析液流速。方法：我们进行了一项回顾性、单中心的先导研究。所有患有终末期肾病（ESKD）或透析依赖性急性肾损伤（AKI）的退伍军人，在2023年2月至2023年6月期间完成了bbbb3小时的血液透析，透析前血尿素氮(BUN) > 20 mg/dL，透析后可用BUN。尿素还原比（URR）和单池Kt/V在不同透析器大小和治疗时间组间比较。结果：59次透析纳入分析。整个队列的平均Kt/V和URR分别为1.26+0.04和60.8+7.3%。达到每Kt/V和URR标准的最低足够清除率的会话百分比分别为50.6%和32.5%。在不同过滤器尺寸（OptifluxTM F160NR或F180NR透析器）和不同持续时间（3,3.5,4小时）的透析时段亚组分析中，f160 /3.5小时、f180 /3.5小时和f180 /4小时组达到最低适当Kt/V的时段百分比分别为44%、50%和58.8%。结论：QD限制在300 ml/min可能会影响急诊透析的充分性。这可以通过延长会话时间来缓解，尽管代价是更高的资源利用率，并提高QD:QB比率。需要在更大的医院队列中进行进一步的研究来阐明这些问题。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Blood Purification 医学-泌尿学与肾脏学

CiteScore

5.80

自引率

3.30%

发文量

审稿时长

6-12 weeks

期刊介绍： Practical information on hemodialysis, hemofiltration, peritoneal dialysis and apheresis is featured in this journal. Recognizing the critical importance of equipment and procedures, particular emphasis has been placed on reports, drawn from a wide range of fields, describing technical advances and improvements in methodology. Papers reflect the search for cost-effective solutions which increase not only patient survival but also patient comfort and disease improvement through prevention or correction of undesirable effects. Advances in vascular access and blood anticoagulation, problems associated with exposure of blood to foreign surfaces and acute-care nephrology, including continuous therapies, also receive attention. Nephrologists, internists, intensivists and hospital staff involved in dialysis, apheresis and immunoadsorption for acute and chronic solid organ failure will find this journal useful and informative. ''Blood Purification'' also serves as a platform for multidisciplinary experiences involving nephrologists, cardiologists and critical care physicians in order to expand the level of interaction between different disciplines and specialities.