Assessment of the length of each hemodialysis session by on-line dialysate urea monitoring.

Abstract:

:Hemodialysis (HD) prescription is usually based on the periodical measurement of the Kt/V achieved in a midweek dialysis session. The purpose of the study was to assess the duration of each HD session to achieve a target dose of dialysis. This allowed to determine whether a given dialysis session may be considered representative of the other HD sessions. Seventy-two HD sessions were studied in 4 stable patients, who were randomly dialyzed during 3 consecutive periods, each lasting 2 weeks, using a different blood flow rate (Qb) in each period: 400, 300 or 200 ml/min. All HD were prolonged to achieve an on-line dialysate urea monitor (UM) Kt/V of 1.2. The UM Kt/V was compared with the Kt/V calculated using pre-HD, post-HD and rebound (45 min post-HD) plasma water urea concentrations. Comparison of the duration of the second midweek dialysis session with the length of the other HD showed 95% concordance intervals (+/-2 SD) of +/-21.08 min for Qb 400, +/-26.88 min for Qb 300 and +/-37.02 min for Qb 200 ml/min. The 95% concordance intervals for whole body urea clearance were +/-32.0, +/-20.36 and +/-15.62 ml/min for Qb 400, 300 and 200 ml/min, respectively. No differences were observed between UM Kt/V and blood-based double-pool Kt/V obtained by the second-generation Daugirdas (1.18 +/- 0.08) and Garred (1.19 +/- 0.08) Kt/V formulas. In conclusion, a great variability was observed between different HD sessions with regard to the whole body urea clearance and the time required to attain a target Kt/V even when the HD characteristics remained constant. The length of every HD required to achieve a target dose of dialysis can be assessed by on-line dialysate urea monitoring.

journal_name

Nephron

journal_title

Nephron

authors

Hernandez-Herrera G,Martin-Malo A,Rodriguez M,Aljama P

doi

10.1159/000046041

subject

Has Abstract

pub_date

2001-09-01 00:00:00

pages

37-42

issue

1

eissn

1660-8151

issn

2235-3186

pii

46041

journal_volume

89

pub_type

临床试验,杂志文章,随机对照试验

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