Comparison of the Dialysis Adequacy Across Four Types of Dialysis Machines in Hemodialysis Patients.

Abstract

Background: Chronic renal failure causes a gradual loss of kidney function. This study compares four types of dialysis machines for blood purification in hemodialysis patients.

Materials and methods: This descriptive-analytical cross-sectional study was conducted in 2024 at the Dialysis Department of Sepehr Dialysis Center and Pasteur Hospital in Kerman Province, Iran. It included 64 dialysis patients selected through convenience sampling. Four different dialysis machines, Fresenius 4008 S, Fresenius 4008 B, ATF1022, and B. Braun, and 102 blood samples were analyzed, with patients undergoing either one or two sessions of hemodialysis. Data were gathered using a questionnaire about demographic and clinical information before and after dialysis. Vital signs and biochemical tests were taken, and dialysis adequacy was measured using KT/V and urea reduction ratio (URR), where K = urea clearance, T = dialysis time, and V = urea distribution volume. Data were analyzed using chi-square, t-tests, and Pearson correlation tests.

Results: The mean (SD) dialysis adequacy (KT/V) among patients was 1.21 (0.41), and the mean (SD) URR was 58.97 (7.65). Only 17.06% of patients achieved a URR greater than 65%, and 21.60% achieved a KT/V greater than 1.20, which are established indicators of hemodialysis adequacy. Although the performance of the four machines varied, with higher values observed for the Fresenius 4008 B (KT/V = 1.16 ± 0.299 and URR = 61.47 ± 8.48), there was no statistically significant difference between dialysis machine types and dialysis adequacy (p > 0.05).

Conclusions: Healthcare officials and stakeholders should examine factors affecting dialysis adequacy and implement newer machines and better quality assurance programs.