{"title":"Online Clearance Monitoring With Electrical Conductance (Dt/V) Versus Blood-driven (Kt/V) of Urea: A Compressional Study.","authors":"Hamid Tayebi-Khosroshahi, Arman Ghahremanzadeh, Morteza Ghojazedeh, Jeiran Dehgan","doi":"","DOIUrl":null,"url":null,"abstract":"<p><strong>Introduction: </strong>The rates of morbidity and mortality in patients receiving routine hemodialysis have been demonstrated to be significantly affected by the dose of HD. As the national and international standards for determination of dialysis adequacy vary among countries, it is necessary to investigate the optimum criteria for HD adequacy. In this study, we aimed at comparing HD adequacy, through two methods of OCM with electrical conductance, and blood-driven Kt/V of urea, in the largest hemodialysis center in Iran.</p><p><strong>Methods: </strong>The value of UC, as an indicator of HD adequacy, was measured 301 times in 120 HD patients via two methods of OCM and blood-driven clearance of urea. For urea- driven Kt/V, two blood samples, each 2 milliliters, were taken from the patient, one before and one after a HD session. For OCM, Fresenius 4008 dialysis machine was set online once the patient was receiving HD. The results of these two methods were analyzed regarding the correlation with patients' demographics, BMI, required weekly HD sessions, type of HD access, type of dialyzers, hematocrit, UDV, ultrafiltration, and blood flow rate.</p><p><strong>Results: </strong>The mean values of UC obtained from blood samples and OCM were almost similar and not significantly different (1.20 vs. 1.11, P = .50). UC values, measured by laboratory assessments were significantly associated with gender, BMI and UDV, while UC values from OCM were significantly associated with gender, BMI, dialyzer type, UDV and ultrafiltration.</p><p><strong>Conclusions: </strong>We conclude that OCM can be used as an effective substitute for laboratory assessment in HD centers to assess HD adequacy. DOI: 10.52547/ijkd.6787.</p>","PeriodicalId":14610,"journal":{"name":"Iranian journal of kidney diseases","volume":null,"pages":null},"PeriodicalIF":0.8000,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Iranian journal of kidney diseases","FirstCategoryId":"3","ListUrlMain":"","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q4","JCRName":"UROLOGY & NEPHROLOGY","Score":null,"Total":0}
引用次数: 0
Abstract
Introduction: The rates of morbidity and mortality in patients receiving routine hemodialysis have been demonstrated to be significantly affected by the dose of HD. As the national and international standards for determination of dialysis adequacy vary among countries, it is necessary to investigate the optimum criteria for HD adequacy. In this study, we aimed at comparing HD adequacy, through two methods of OCM with electrical conductance, and blood-driven Kt/V of urea, in the largest hemodialysis center in Iran.
Methods: The value of UC, as an indicator of HD adequacy, was measured 301 times in 120 HD patients via two methods of OCM and blood-driven clearance of urea. For urea- driven Kt/V, two blood samples, each 2 milliliters, were taken from the patient, one before and one after a HD session. For OCM, Fresenius 4008 dialysis machine was set online once the patient was receiving HD. The results of these two methods were analyzed regarding the correlation with patients' demographics, BMI, required weekly HD sessions, type of HD access, type of dialyzers, hematocrit, UDV, ultrafiltration, and blood flow rate.
Results: The mean values of UC obtained from blood samples and OCM were almost similar and not significantly different (1.20 vs. 1.11, P = .50). UC values, measured by laboratory assessments were significantly associated with gender, BMI and UDV, while UC values from OCM were significantly associated with gender, BMI, dialyzer type, UDV and ultrafiltration.
Conclusions: We conclude that OCM can be used as an effective substitute for laboratory assessment in HD centers to assess HD adequacy. DOI: 10.52547/ijkd.6787.
导读:接受常规血液透析的患者的发病率和死亡率已被证明受到HD剂量的显著影响。由于测定透析充分性的国家和国际标准因国家而异，因此有必要研究透析充分性的最佳标准。在本研究中，我们在伊朗最大的血液透析中心，通过电导OCM和血液驱动尿素Kt/V两种方法来比较HD充分性。方法:对120例HD患者，通过OCM和血清尿素两种方法测定UC值301次，UC值作为HD充分性的指标。对于尿素驱动的Kt/V，从患者身上取两份血液样本，每份2毫升，一份在HD会议之前，一份在之后。对于OCM，费森尤斯4008透析机在患者接受HD治疗后立即上线。分析两种方法的结果与患者人口统计学特征、BMI、每周HD治疗次数、HD通道类型、透析器类型、血细胞比容、UDV、超滤和血流量的相关性。结果:血标本UC与OCM的平均值基本相似，差异无统计学意义(1.20 vs. 1.11, P = .50)。实验室评估的UC值与性别、BMI和UDV显著相关，而OCM的UC值与性别、BMI、透析器类型、UDV和超滤显著相关。结论:我们的结论是，OCM可以作为HD中心评估HD充分性的有效替代实验室评估。DOI: 10.52547 / ijkd.6787。
期刊介绍：
The Iranian Journal of Kidney Diseases (IJKD), a peer-reviewed journal in English, is the official publication of the Iranian Society of Nephrology. The aim of the IJKD is the worldwide reflection of the knowledge produced by the scientists and clinicians in nephrology. Published quarterly, the IJKD provides a new platform for advancement of the field. The journal’s objective is to serve as a focal point for debates and exchange of knowledge and experience among researchers in a global context. Original papers, case reports, and invited reviews on all aspects of the kidney diseases, hypertension, dialysis, and transplantation will be covered by the IJKD. Research on the basic science, clinical practice, and socio-economics of renal health are all welcomed by the editors of the journal.
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