Accuracy and clinical utility of dialysis dose measurement using online ionic dialysance
Φόρτωση...
Ημερομηνία
Συγγραφείς
Katopodis, K. P.
Hoenich, N. A.
Τίτλος Εφημερίδας
Περιοδικό ISSN
Τίτλος τόμου
Εκδότης
Περίληψη
Τύπος
Είδος δημοσίευσης σε συνέδριο
Είδος περιοδικού
peer-reviewed
Είδος εκπαιδευτικού υλικού
Όνομα συνεδρίου
Όνομα περιοδικού
Clin Nephrol
Όνομα βιβλίου
Σειρά βιβλίου
Έκδοση βιβλίου
Συμπληρωματικός/δευτερεύων τίτλος
Περιγραφή
BACKGROUND: Statistical associations between urea removal and survival have been described in a number of publications. Urea removal during treatment may be quantified by the delivered dose of dialysis. Methods in clinical use to measure delivered dose are retrospective and reliant on accurate blood sampling. The new generation of single patient proportionating systems incorporate the facility to automatically measure ionic dialysance throughout dialysis. METHODS: In a prospective study on 9 anuric patients with a stable dialysis prescription, we have compared the agreement of the dose of dialysis determined from ionic dialysance (Dt/V) with that derived from equilibriated Kt/V (eKt/V) and Kt/V measured by direct dialysis quantification (Kt/V(DDQ)) using 2 types of hemodialysis membrane (hemophan and low-flux polysulfone). The variability of the delivered dose over a 1-month period was also determined. RESULTS: Ionic dialysance was independent of membrane type. It was comparable to that established for plasma urea water clearance for hemophan but lower for polysulfone (p < 0.001). The mean (+/- SD) delivered dose of dialysis (Dt/V) was similar for both membranes (1.18 +/- 0.15 (hemophan) and 1.18 +/- 0.11 (low-flux polysulfone)). Bland Altman comparisons showed the limits of agreement between Dt/V and Kt/V(DDQ) were +/- 0.17 and for Dt/V compared with eKt/V +/- 0.15. A 1-month measurement of Dt/V demonstrated considerable treatment to treatment variability indicating that delivered dose cannot be considered stable. CONCLUSION: The availability of online measurement of ionic dialysance provides a step towards monitoring dialysis more closely at the time of delivery, and its clinical application will ensure that a more constant dialysis dose is delivered.
Περιγραφή
Λέξεις-κλειδιά
Adult, Aged, Hemodialysis Solutions/*administration & dosage, Humans, Kidney Failure, Chronic/metabolism/therapy, Membranes, Artificial, Middle Aged, Models, Biological, Online Systems, Prospective Studies, Renal Dialysis/instrumentation/*methods, Reproducibility of Results, Urea/metabolism
Θεματική κατηγορία
Παραπομπή
Σύνδεσμος
http://www.ncbi.nlm.nih.gov/pubmed/11924753
Γλώσσα
en
Εκδίδον τμήμα/τομέας
Όνομα επιβλέποντος
Εξεταστική επιτροπή
Γενική Περιγραφή / Σχόλια
Ίδρυμα και Σχολή/Τμήμα του υποβάλλοντος
Πανεπιστήμιο Ιωαννίνων. Σχολή Επιστημών Υγείας. Τμήμα Ιατρικής