Ami M Patel, Nazli Atefi, Jagman Chahal, Abutaleb Ahsan Ejaz
{"title":"中期透析液流量与透析充分性。","authors":"Ami M Patel, Nazli Atefi, Jagman Chahal, Abutaleb Ahsan Ejaz","doi":"10.1159/000545703","DOIUrl":null,"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 (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.</p><p><strong>Results: </strong>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.</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":"1-13"},"PeriodicalIF":2.2000,"publicationDate":"2025-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"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\":null,\"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 (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.</p><p><strong>Results: </strong>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.</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\":\"1-13\"},\"PeriodicalIF\":2.2000,\"publicationDate\":\"2025-04-21\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Blood Purification\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1159/000545703\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q3\",\"JCRName\":\"HEMATOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Blood Purification","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1159/000545703","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"HEMATOLOGY","Score":null,"Total":0}
Mid-Range Dialysate Flow and Adequacy of Dialysis.
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. .
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.
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