Does monitoring of pre-/post-dialyzer pressure difference improve efficiency in intermittent hemodialysis?

Details

Serval ID
serval:BIB_6D315ECF874F
Type
Article: article from journal or magazin.
Collection
Publications
Title
Does monitoring of pre-/post-dialyzer pressure difference improve efficiency in intermittent hemodialysis?
Journal
Blood Purification
Author(s)
Gabutti L., Colucci G., Martella A., Schönholzer C., Marone C.
ISSN
0253-5068 (Print)
ISSN-L
0253-5068
Publication state
Published
Issued date
2003
Volume
21
Number
4-5
Pages
294-300
Language
english
Notes
Publication types: Clinical Trial ; Journal Article ; Research Support, Non-U.S. Gov't
Publication Status: ppublish
Abstract
BACKGROUND: Continuous monitoring of pre-/post-dialyzer pressure difference (DeltaP) is widely used in continuous renal replacement therapies to monitor extracorporeal circuit function. The aim of this study was to verify whether DeltaP may help to identify chronic subclinical worsening of dialysis quality due to incomplete dialyzer clotting in intermittent hemodialysis.
METHODS: Nine chronic hemodialysis patients were enrolled in the study and dialyzed twice (high-flux polysulfone dialyzer) with DeltaP and urea-clearance monitoring: the first session with a standard anticoagulation and the second without. To verify whether a visible clotting of the dialyzer precedes or follows a significant DeltaP increase, we checked the dialyzers for the presence of red clots after a saline flush performed when a 50% increase in DeltaP was registered.
RESULTS: In the second dialysis session after a 50% increase in DeltaP (documented in 7/9 patients), all dialyzers, after saline flush, showed a visible fiber clotting but not a significant reduction (>15%) in urea clearance. In the majority of the patients (6/7), until a few minutes before complete occlusion of the extracorporeal circuit, the urea clearance did not change significantly (-8.9 +/- 12.7%).
CONCLUSIONS: The usual check of the presence or absence of red clots in the dialyzer at the end of the dialysis session is enough, in the absence of red clots, to ensure that dialyzer efficiency is maintained during the whole treatment. Contrary to what is applied in CRRT, a continuous monitoring of DeltaP during intermittent hemodialysis would not significantly help to unmask unnoticed inefficient hemodialysis sessions.
Keywords
Adult, Anticoagulants/pharmacology, Anticoagulants/therapeutic use, Blood Coagulation, Equipment Failure Analysis/methods, Female, Humans, Kinetics, Male, Membranes, Artificial, Middle Aged, Polymers, Pressure, Renal Dialysis/methods, Renal Dialysis/standards, Sulfones
Pubmed
Create date
24/07/2013 10:16
Last modification date
16/04/2020 6:26
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