Utility of a water-sparing approach for reducing dialysate flow rates in hospitalized patients with kidney failure.

IF 1.4 4区医学 Q4 ENGINEERING, BIOMEDICAL

International Journal of Artificial Organs Pub Date : 2025-05-05 DOI:10.1177/03913988251337228

Amay Parikh, Kirsten Drake, Craig Woda, Cynthia D'Alessandri-Silva, Michael Aragon

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引用次数: 0

Abstract

Introduction: Hemodialysis (HD) represents a necessary medical intervention for patients with end stage kidney disease (ESKD) with a high carbon footprint that significantly consumes natural resources (i.e. water). Reduction of dialysate flow rate is one strategy that directly targets water waste during HD.

Methods: A retrospective multicenter, observational study was conducted over 12 months in patients with AKI-D and ESKD to evaluate treatments with mid-range dialysate flow rates set at Qd 300 mL/min (Green HD) using the Tablo^® HD System (Outset Medical) versus flow rates ⩾Qd 500 mL/min (Conventional systems).

Results: One thousand one hundred ninety-five treatments were performed in 433 patients using Green HD (Qd = 300 mL/min, n = 575) and Conventional systems (Qd ⩾500 mL/min, n = 620). Mean Qd for Green HD was 300.0 ± 0.0 and mean Qd for the Conventional systems was 686.6 ± 88.3 mL/min. Mean blood flow rates were significantly lower among patients treated with Green HD. Reductions in TACurea and post dialysis serum potassium were similar between the two groups. Estimates for resource utilization were lower using Green HD compared to Conventional systems.

Conclusion: These findings support that higher dialysate flow rates using Conventional systems yield minimal if any benefit in small solute clearance compared to mid-range flow rates. Green HD using the Tablo^® HD System results in comparable benefits in ESKD patients with significant conservation of water resources.

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节水方法降低住院肾衰竭患者透析液流速的效用。

血液透析（HD）是终末期肾病（ESKD）患者的一种必要的医疗干预措施，其高碳足迹显著消耗自然资源（即水）。降低透析液流速是HD过程中直接针对水浪费的一种策略。方法：在AKI-D和ESKD患者中进行了超过12个月的回顾性多中心观察性研究，以评估使用Tablo®HD系统（开始医疗）将中期透析液流速设置为Qd 300 mL/min （Green HD）与流速大于或小于Qd 500 mL/min（常规系统）的治疗。结果：在433名患者中使用Green HD （Qd = 300 mL/min, n = 575）和常规系统（Qd大于或等于500 mL/min， n = 620）进行了195次治疗。Green HD系统的平均Qd为300.0±0.0，常规系统的平均Qd为686.6±88.3 mL/min。在接受Green HD治疗的患者中，平均血流量显著降低。两组间TACurea和透析后血钾的降低相似。与传统系统相比，使用绿色高清系统对资源利用率的估计更低。结论：这些研究结果表明，与中等流速相比，使用传统系统的高透析液流速对小溶质清除率的影响微乎其微。使用Tablo®HD系统的Green HD在ESKD患者中具有相当的益处，并且显着节约了水资源。

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

International Journal of Artificial Organs 医学-工程：生物医学

CiteScore

3.40

自引率

5.90%

发文量

审稿时长

3 months

期刊介绍： The International Journal of Artificial Organs (IJAO) publishes peer-reviewed research and clinical, experimental and theoretical, contributions to the field of artificial, bioartificial and tissue-engineered organs. The mission of the IJAO is to foster the development and optimization of artificial, bioartificial and tissue-engineered organs, for implantation or use in procedures, to treat functional deficits of all human tissues and organs.