P1116IS DIALYSIS ADEQUACY AMELIORATED AFTER INCREASING DIALYSATE FLOW RATE IN CHRONIC HEMODIALYSIS? - ONE YEAR FOLLOW-UP

Autor: Theodoros Chiras, Eugenia Karakou, Nikolaos Trakas, Aggeliki Barbatsi, Jacob Skarakis, Makrouhi Sonikian
Rok vydání: 2020
Předmět:
Zdroj: Nephrology Dialysis Transplantation. 35
ISSN: 1460-2385
0931-0509
DOI: 10.1093/ndt/gfaa142.p1116
Popis: Background and Aims Hemodialysis (HD) adequacy, as measured by single pool (sp) Kt/V and urea reduction rate (URR), has been reported to be ameliorated after increasing dialysate flow rate (DFR). However, this is a matter of controversy as no benefit has been observed with dialyzers incorporating features to enhance dialysate flow distribution. We investigated the effect of increasing DFR on dialysis adequacy and on various laboratory parameters. Method Twenty-three patients, M/F=20/3, aged 65(44-89) years, dialyzed thrice weekly for 50(6-274) months, using polysulfone low flux dialyzers, participated in an annual randomized cross-over study. Patients were dialyzed with DFR of 500 ml/min and 700 ml/min for 6 consecutive months respectively, according to their usual dialysis prescription and with ultrafiltration volumes according to clinical need. Blood was sampled before and at the end of midweek sessions at the beginning of the first, 7th and 13rd month for urea, creatinine, potassium, sodium, albumin, total Ca and phosphate (sP). URR, spKt/V, corrected for albumin Ca(sCa) and sCa x sP product (CaxP) values were calculated. Results Under both 500 and 700 ml/min DFRs used, the expected post-dialysis alterations were found: decreased values in serum urea (respectively 161,5±38,0 to 49,9±20.1-p Conclusion DFR increase from 500 to 700 ml/min did not lead to favorable effects on dialysis adequacy but resulted in post-dialysis amelioration of serum calcium and phosphate levels and may be useful in cases of hypercalcemia, hyperphosphatemia and calcifications. DFR increase utility needs further investigation in patients with disorders of calcium-phosphate metabolism.
Databáze: OpenAIRE
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