Improved urea reduction ratio and Kt/V in large hemodialysis patients using two dialyzers in parallel
| Autor: | Karl G. Koenig, Allen W. Helmandollar, Kathleen M. Powers, Michael J. Wilkowski, W. Kline Bolton |
|---|---|
| Rok vydání: | 2000 |
| Předmět: |
Adult
Male medicine.medical_specialty medicine.medical_treatment Health Status Urea reduction ratio Urology chemistry.chemical_compound Renal Dialysis Internal medicine medicine Humans Urea Prospective Studies Dialysis Aged Cross-Over Studies business.industry Body Weight Equipment Design Middle Aged medicine.disease Crossover study Endocrinology chemistry Nephrology Kt/V Kidney Failure Chronic Female Hemodialysis Iohexol business Kidney disease medicine.drug |
| Zdroj: | American journal of kidney diseases : the official journal of the National Kidney Foundation. 35(2) |
| ISSN: | 1523-6838 |
| Popis: | Delivered dose of hemodialysis (HD) in large patients with end-stage renal disease is often less than adequate. Fourteen chronic HD patients with weights greater than 80 kg participated in a prospective, cross-over study comparing urea reduction ratio (URR +/- SEM) and the fractional clearance index for urea (eKt/V(urea) +/- SEM) on a single polysulfone dialyzer for a control (HDC) period of 4 weeks versus clearances obtained with two dialyzers in parallel during an intervention (HDP) period of 4 weeks. Clearance of the surrogate middle molecule iohexol (C(Io)) was also measured. Health status was assessed with the SF-36. Blood and dialysate flow rates and duration of HD sessions were constant. URR increased from 0.67 +/- 0.006 during HDC to 0.72 +/- 0.006 with HDP (P < 0.0001). eKt/V(urea) increased from 1.16 +/- 0.021 to 1.34 +/- 0.021 (P < 0.0001). Increased URR and eKt/V(urea) occurred in all 14 during HDP (P < 0.05). C(Io) during HDP averaged 182 +/- 7.7 mL/min compared with 131 +/- 5.4 mL/min in HDC sessions (P < 0.00001). Health status improved in six of eight categories. Expense increased approximately $14.27 per dialysis with HDP. In 11 of 14 patients continued on two dialyzers in parallel for 1 year, monthly eKt/V averaged 1.46 +/- 0.066, and health status further improved in five of eight categories. In large patients, two dialyzers in parallel increased urea and iohexol clearance. Increased urea clearance was maintained for 1 year, and health status improved. |
| Databáze: | OpenAIRE |
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