Blood Purification最新文献

{"title":"Impact of No Anticoagulation, Citrate Anticoagulation, and Heparin Anticoagulation on CRRT Outcomes in Patients with Hyperlactatemia: A Retrospective Cohort Study.","authors":"Yaxin Xiong, Xiqing Luo, Jianpeng Wang, Quankuan Gu, Jiuyue Sun, Ze Meng, Shuang Tang, Jun Lyu, Mingyan Zhao, Xianglin Meng","doi":"10.1159/000546195","DOIUrl":"10.1159/000546195","url":null,"abstract":"<p><strong>Introduction: </strong>Continuous renal replacement therapy (CRRT) is one of the most critical interventions in the intensive care unit, and anticoagulation is essential to ensure its efficacy. Regional citrate anticoagulation (RCA) has been widely adopted in clinical practice due to its reduced risk of bleeding complications. However, the suitability of RCA for CRRT in patients with hyperlactatemia remains controversial.</p><p><strong>Methods: </strong>This study aimed to evaluate the efficacy and safety of different anticoagulation strategies (heparin systemic anticoagulation, RCA, and no anticoagulation) during CRRT in critically ill patients with hyperlactatemia. Using a retrospective cohort design, we analyzed clinical data from the MIMIC-IV v3.0 database, employing propensity score matching and multivariable Cox regression models to adjust for confounding factors.</p><p><strong>Results: </strong>Our findings demonstrated that compared to the no-anticoagulation group, the citrate group exhibited significantly lower 28-day, 60-day, and 90-day mortality risks, with hazard ratios (HRs) of 0.623, 0.650, and 0.657, respectively. In contrast, the heparin group showed a significant reduction only in 28-day mortality risk (HR = 0.625). These results were further validated in the matched cohort, indicating that RCA significantly improves clinical outcomes and reduces mortality in hyperlactatemia patients requiring CRRT.</p><p><strong>Conclusion: </strong>In summary, our study indicates that citrate anticoagulation significantly improves the prognosis of CRRT in patients with hyperlactatemia, suggesting its potential as a preferred anticoagulation strategy in this clinical setting.</p>","PeriodicalId":8953,"journal":{"name":"Blood Purification","volume":" ","pages":"1-13"},"PeriodicalIF":2.2,"publicationDate":"2025-05-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143961740","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Current Experience Using the Selective Cytopheretic Device for Continuous Immunomodulation in Acute Kidney Injury and Multiorgan Failure.","authors":"Stuart L Goldstein, H David Humes","doi":"10.1159/000546219","DOIUrl":"https://doi.org/10.1159/000546219","url":null,"abstract":"<p><p>Introduction Sepsis and sepsis-associated acute kidney injury (AKI) are associated with increased patient morbidity and mortality. The immediate host response aimed at combating infection can become dysregulated, leading to uncontrolled inflammation and multi-organ failure, including AKI. Therapies targeting one protein component of the sepsis pathway have largely failed to improve patient outcomes, and currently only organ support therapies are used clinically to provide time for innate organ recovery to occur. The Selective Cytopheretic Device (SCD) is a continuous cell processing immunomodulatory device that attracts activated neutrophils and monocytes its biomimetic membrane surface. The activated leukocytes are transformed to a less pro-inflammatory phenotype and released back into the circulation when exposed to low ionized calcium concentration established in the SCD by standard regional citrate anticoagulation protocols used in continuous renal replacement therapy. Review In this review, we detail the history of the SCD and our experience with it, from discovery to pre-clinical testing to translational research application at the bedside. We discuss the SCD mechanism of action, its immunomodulatory effect, and the human studies involving critically ill adult pediatric patients with AKI who require continuous renal replacement therapy as part of the standard of care. We conclude discussing ongoing and future application of the SCD in both acute and chronic inflammatory states that would benefit from immunomodulation.</p>","PeriodicalId":8953,"journal":{"name":"Blood Purification","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-05-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143973815","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diluted Regional Citrate Anticoagulation for Continuous Renal Replacement Therapy in Pediatric Patients: Suggested Practice Points.","authors":"Sidharth Kumar Sethi, Ashita Tolwani, Omer S Ashruf, Mihika Aggarwal, Girish Chandra Bhatt, Aishwarya Nair, Kritika Soni, Savita Savita, Shyam Bihari Bansal, Khalid Alhasan, Timothy Bunchman, Rupesh Raina","doi":"10.1159/000545674","DOIUrl":"https://doi.org/10.1159/000545674","url":null,"abstract":"<p><p>Introduction Continuous renal replacement therapy (CRRT) is increasingly used in critical pediatric patients with acute kidney injury (AKI). The choice of anticoagulant is vital to minimize circuit clotting and bleeding complications. Regional citrate anticoagulation (RCA) is preferred for its safety profile, particularly in critically ill pediatric patients who are susceptible to bleeding. Methods A comprehensive literature search was conducted using PubMed, Google Scholar, and Cochrane databases following PRISMA guidelines. Keywords included 'diluted citrate,' 'regional citrate anticoagulation,' 'continuous renal replacement therapy,' 'pediatrics,' and 'adverse effects.' Studies were included if they involved neonates and pediatric patients, reported citrate concentration, and safety and efficacy outcomes of RCA in CRRT. Data were extracted on study characteristics, citrate concentration, circuit lifespan, metabolic and electrolyte disturbances, and other adverse effects. Results A total of 16 studies met the inclusion criteria. RCA was associated with fewer clotting events and a longer median circuit life compared to heparin. However, complications such as metabolic alkalosis, hypocalcemia, and hypernatremia were noted. In our single-centre experience, dilute citrate anticoagulation was used in 16 pediatric patients undergoing CRRT, showing promising results with reduced clotting and prolonged circuit life. The modified pediatric citrate protocol presented aims to address complications by using a diluted citrate solution. Conclusions RCA is effective in prolonging circuit life and reducing clotting in pediatric CRRT. The modified pediatric citrate protocol presents a safer alternative by reducing the risk of metabolic and electrolyte disturbances. Ongoing monitoring of calcium and electrolyte levels is essential to mitigate potential complications. This protocol may standardize RCA use in pediatric CRRT, improving safety and outcomes for critically ill children with AKI.</p>","PeriodicalId":8953,"journal":{"name":"Blood Purification","volume":" ","pages":"1-33"},"PeriodicalIF":2.2,"publicationDate":"2025-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143977343","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Randomised Prospective Crossover Study on the Effects of Medium Cut-Off Membranes on FGF-23 and Inflammatory Mediators in Patients Receiving Regular Haemodialysis.","authors":"Saif Al-Chalabi, Smeeta Sinha, Philip A Kalra, Dawn Evans, Darren Green, Leon Schurgers, Dimitrios Poulikakos","doi":"10.1159/000545745","DOIUrl":"10.1159/000545745","url":null,"abstract":"<p><strong>Introduction: </strong>In contrast to high-flux dialysis (HFD) membranes, medium cut-off membranes (MCO) can potentially remove a wide range of middle molecules. Our study aimed to compare the clearance rate (CR) of fibroblast growth factor 23 (FGF-23) and other selected inflammatory cytokines between medium MCO and HFD membranes and investigate the intrasubject stability of these biomarkers.</p><p><strong>Methods: </strong>This prospective randomised case-crossover study recruited 20 adult patients who were randomised into two groups: group A: to start with 1 week of thrice-weekly dialysis using HFD membrane followed by a 3-week washout period and then 1 week of dialysis with an MCO membrane. Group B followed the reverse sequence. Blood samples were taken before and after each dialysis session for the analysis of the assessed biomarkers (FGF-23, interleukin-6 [IL-6], interleukin-18 [IL-18], high-sensitivity C-reactive protein [hsCRP], and dephosphorylated uncarboxylated matrix Gla protein [dp-ucMGP]). Wilcoxon signed rank and paired t tests were used for comparison between the membranes. One-way repeated measures ANOVA or Friedman tests were used for the intrasubject stability of the biomarkers.</p><p><strong>Results: </strong>The use of both MCO and HFD membranes resulted in a significant reduction of FGF-23 levels and other selected inflammatory cytokines. However, there was no significant difference in the CR: FGF-23 (0.31 vs. 0.23], p = 0.242), IL-6 (0.19 vs. 0.12, p = 0.215), IL-18 (-0.05 vs. -0.03, p = 0.704), dp-ucMGP (0.33 vs. 0.33, p = 0.903), and hsCRP (-0.05 vs. -0.08, p = 0.107). There was no significant intrasubject variability for all assessed biomarkers except in pre-dialysis high hsCRP levels when using HFD membrane.</p><p><strong>Conclusion: </strong>The use of both MCO and HFD membranes resulted in a significant reduction of FGF-23 levels and other selected inflammatory cytokines. However, the MCO membrane did not demonstrate a significant advantage over the HFD in the short term. There was no significant intrasubject variability for all assessed biomarkers apart from hsCRP.</p>","PeriodicalId":8953,"journal":{"name":"Blood Purification","volume":" ","pages":"1-13"},"PeriodicalIF":2.2,"publicationDate":"2025-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12105827/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143961043","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mid-Range Dialysate Flow and Adequacy of Dialysis.","authors":"Ami M Patel, Nazli Atefi, Jagman Chahal, Abutaleb Ahsan Ejaz","doi":"10.1159/000545703","DOIUrl":"10.1159/000545703","url":null,"abstract":"<p><strong>Introduction: </strong>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.</p><p><strong>Methods: </strong>We conducted a retrospective, single-center pilot study. All veterans with end-stage kidney disease or dialysis-dependent acute kidney injury, who completed ≥3 h of hemodialysis and had pre-dialysis 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.</p><p><strong>Results: </strong>Fifty-nine 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 (Optiflux™ F160NR or F180NR dialyzers) and varying duration (3, 3.5, 4 h), the percentage of sessions achieving minimum adequate Kt/V in the F160/3.5 h, F180/3.5 h and F180/4 h groups were 44%, 50%, and 58.8%, respectively.</p><p><strong>Conclusion: </strong>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.</p>","PeriodicalId":8953,"journal":{"name":"Blood Purification","volume":" ","pages":"1-6"},"PeriodicalIF":2.2,"publicationDate":"2025-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143977468","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Investigating the Effects of Moxibustion on Gastrointestinal Function and Gut Microbiota in Chronic Renal Failure: A CARE Non-Placebo Randomized Controlled Study in Peritoneal Dialysis Patients.","authors":"Weiguo Yao, Chunli Yu, Aiying Xiong, Li Li, Junli Gao, Kun Liu","doi":"10.1159/000545242","DOIUrl":"10.1159/000545242","url":null,"abstract":"<p><strong>Introduction: </strong>Moxibustion is regarded as a complementary and alternative treatment for chronic renal failure (CRF) patients.</p><p><strong>Methods: </strong>This study was a randomized controlled trial, and we collected case data from 52 CRF patients who received moxibustion combined with PD treatment (moxibustion group) and 50 CRF patients who only received PD treatment (control group) in our hospital from March 2020 to February 2022. After a 12-week treatment cycle, the changes in blood routine test indicators, blood electrolytes, routine biochemical indicators, 24 h urinary protein quantification, and gastrointestinal function indicators before and after treatment were compared between the two groups. The primary outcome was blood urea nitrogen (BUN) levels, indicative of kidney function.</p><p><strong>Results: </strong>Fifty two patients remained in the moxibustion group and 50 in the control group. After 12 weeks of treatment, the moxibustion group demonstrated significantly lower serum potassium and phosphorus levels than before treatment. Regarding biochemical blood analysis, the moxibustion group had significantly lower BUN levels, 24 h urinary protein quantification, and parathyroid hormone after treatment compared with the control group. However, although the serum creatinine, alkaline phosphatase, alanine aminotransferase, and aspartate aminotransferase were numerically lower in the moxibustion group, the difference between the two groups was not statistically significant. The moxibustion group had improved gastrointestinal function, in terms of increased motilin and cholecystokinin levels, compared to the control group.</p><p><strong>Conclusion: </strong>Moxibustion combined with PD can improve renal and gastrointestinal functions and regulate the structure of the gut microbiota to in CRF patients.</p>","PeriodicalId":8953,"journal":{"name":"Blood Purification","volume":" ","pages":"1-15"},"PeriodicalIF":2.2,"publicationDate":"2025-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143972055","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Drug Removal by Hemoadsorption.","authors":"Ilona Lemagnen, Céline Monard, Maxime Palluau, Layla Bergamaschi, Taku Furukawa, Rinaldo Bellomo, Antoine Schneider","doi":"10.1159/000545804","DOIUrl":"10.1159/000545804","url":null,"abstract":"<p><strong>Background: </strong>There is growing interest in hemoadsorption (HA) therapies in critically ill patients although their precise indications remain to be established. Several devices are available on the market with heterogeneous properties and capabilities.</p><p><strong>Summary: </strong>Due to the nonspecific removal associated with most HA techniques, concerns have been raised on their unintended removal of drugs such as anti-infectives in sepsis. On the other hand, drug removal might be beneficial in certain situations for instance antithrombotic medications in patients requiring emergency surgery or in case of accidental or self-induced intoxication. In this review, we summarize available in vitro, in vivo, and clinical studies reporting on the influence of various HA techniques on drugs pharmacokinetics.</p><p><strong>Key message: </strong>We conclude that further studies should aim at providing drug dosing recommendations during HA and confirm its safety, efficacy, and practicalities when used for intoxications.</p>","PeriodicalId":8953,"journal":{"name":"Blood Purification","volume":" ","pages":"1-13"},"PeriodicalIF":2.2,"publicationDate":"2025-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143961054","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Meta-Analysis of Influencing Factors of Mortality in Chinese Patients with Liver Failure Undergoing Plasma Exchange.","authors":"Xin Zhang, Huafen Zhang, Haiyin Jiang, Hui Chen, Qinxian Chen","doi":"10.1159/000545270","DOIUrl":"10.1159/000545270","url":null,"abstract":"<p><strong>Introduction: </strong>This meta-analysis aimed to evaluate the determinants that influence mortality of individuals with liver failure who are undergoing the treatment of plasma exchange (PE).</p><p><strong>Methods: </strong>The search for relevant literature was conducted from the beginning of the database records up to January 5, 2024, encompassing a range of databases such as PubMed, Embase, the Cochrane Library, Web of Science, as well as Chinese databases including China National Knowledge Infrastructure (CNKI), WanFang, and VIP. For the analysis of continuous variables, the weighted mean difference was utilized, while for categorical variables, the odds ratio was employed. Both statistical measures were presented alongside their respective 95% confidence intervals. Subgroup analyses were conducted based on liver failure type, volume of plasma exchanged, and HBV etiology.</p><p><strong>Results: </strong>In total, 33 studies involving 5,842 patients were included. Older age, a higher Model for End-Stage Liver Disease score, the presence of hepatic encephalopathy, cirrhosis, hepatorenal syndrome, and peritonitis, elevated aspartate transaminase levels, low albumin level, low prothrombin activity, prolonged prothrombin time, low platelet, and white blood cell counts were associated with mortality in Chinese patients with liver failure who underwent PE (all p < 0.05). However, these influencing factors could vary depending on the type of liver failure and the exchange volume during PE.</p><p><strong>Conclusion: </strong>Several demographic indicators, liver function indicators, coagulation indicators, and routine blood are associated with mortality in patients with liver failure undergoing PE. This study may provide important clinical guidance for the care of patients with liver failure, helping to improve patient survival.</p>","PeriodicalId":8953,"journal":{"name":"Blood Purification","volume":" ","pages":"1-18"},"PeriodicalIF":2.2,"publicationDate":"2025-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143953120","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Long-Term Safety of \"4-Hour\" Hemoadsorption Combined with Hemodialysis in Maintenance Hemodialysis Patients: A Multicenter Prospective Cohort Study.","authors":"Dongliang Zhang, Cuiping Liu, Tao Yang, Jingxin Zhao, Xiaofei Wang, Liping Zhang, Yuanyuan Li, Yangyang Shen, Yanjun Gao, Hongjuan Zhang","doi":"10.1159/000545988","DOIUrl":"10.1159/000545988","url":null,"abstract":"<p><strong>Introduction: </strong>Current guidelines recommend limiting hemoadsorption (HA) duration to 2 h during hemodialysis (HD) sessions due to theoretical concerns about adsorbent saturation and clotting risks. This multicenter prospective cohort study evaluated the long-term safety and efficacy of a novel \"4Hs\" protocol (4-h HA-HD with blood flow >250 mL/min).</p><p><strong>Methods: </strong>78 maintenance HD patients from four centers underwent 26 weeks of 4Hs therapy. Key outcomes included dialysis adequacy (spKt/V, urea reduction ratio [URR]), uremic toxin (UT) clearance (indoxyl sulfate [IS], p-cresyl sulfate, β2 microglobulin [B2MG]), clotting rates, and adverse events. Statistical comparisons were made against pre-study conventional HA+HD (2-h HA) data using paired t-tests and repeated-measures ANOVA.</p><p><strong>Results: </strong>The 4Hs protocol demonstrated non-inferior safety to conventional HA+HD, with comparable clotting rates (1.79% vs. 1.62%, p = 0.665) and no significant differences in anemia markers or hypoalbuminemia. Dialysis efficacy improved significantly: spKt/V increased by 0.28 (p = 0.012), URR by 1.18% (p = 0.003), and UT reduction rates (IS: 56.17% vs. 40.14%, p < 0.001; pCS: 47.39% vs. 35.91%, p < 0.001; B2MG: 55.82% vs. 48.41%, p < 0.001). Albumin loss remained comparable between protocols (Δ 0.5 g/L, p > 0.05).</p><p><strong>Conclusion: </strong>Extending HA duration to 4 h with high-flow hemodynamics (Qb >250 mL/min) is safe and enhances toxin clearance without increasing clotting risks. These findings challenge current SOP limitations on HA duration and support protocol optimization in maintenance HD patients.</p>","PeriodicalId":8953,"journal":{"name":"Blood Purification","volume":" ","pages":"1-11"},"PeriodicalIF":2.2,"publicationDate":"2025-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143974202","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of Lowering Dialysate Flow Rate on Dialysis Dose and Laboratory Values.","authors":"Maryn Gardner, Nicole E Wyatt, Neil Sanghani, Ahmed Attia, Andrew Guide, Robert A Greevy, Megha Salani, Osama El Shamy","doi":"10.1159/000545898","DOIUrl":"10.1159/000545898","url":null,"abstract":"<p><strong>Introduction: </strong>The rationale behind using higher dialysate flow rates stems from the idea of maximizing a dialysis membrane's extraction ratio. Subsequent developments in dialysis membrane design, including the hollow fiber undulations, spacer yarns, and altering the fiber packing density, helped reduce blood and dialysate flow mismatch in dialysis membranes.</p><p><strong>Methods: </strong>This is a single-center retrospective analysis of in-center dialysis patients. Adult (age ≥18 years) in-center hemodialysis patients who were receiving dialysis at the centers 3 months prior to and 3 months following the change in dialysate flow rates were included in the study (December 2022 to May 2023). Dialysate flow rates were reduced from 800 to 600 mL/min - using the same access and dialysis membrane.</p><p><strong>Results: </strong>Sixty-eight patients were enrolled in the study. The change of dialysate flow rate did not result in a statistically significant change in dialysis dose (Kt/Vurea). All regression coefficients were below 0.05 (i.e., a 0.05 change in dialysis dose for flow rate 600 vs. 800 mL/min). Significant associations were found between dialysis dose and both the blood flow rate and dialysate sodium, but these were also clinically negligible differences. Analysis of patients' laboratory testing showed no statistically significant difference in serum electrolyte values (sodium, potassium, bicarbonate, blood urea nitrogen, and creatinine).</p><p><strong>Conclusion: </strong>In patients treated using the same dialysate filter and dialysis access, changing the dialysate flow rate from 800 to 600 mL/min does not result in clinically significant changes in either patients' measured serum electrolytes or dialysis dose.</p>","PeriodicalId":8953,"journal":{"name":"Blood Purification","volume":" ","pages":"1-4"},"PeriodicalIF":2.2,"publicationDate":"2025-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143953354","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}