Reasonably short hemodialysis time can be achieved without ultra-high efficiency dialyzers and without ultrafiltration-controlled delivery systems.
To evaluate the ability to provide short hemodialysis (less than 9 hr per week) without the requirement for costly ultra-high efficiency dialyzers and ultrafiltration control delivery systems, 69 patients maintained on chronic hemodialysis were studied. Standard dialysis was delivered with bicarbonate dialysate, Baxter CF 1211 dialyzers, QB = 300 ml/min, mean time 215 min. The mean KT/V was 1.16. Hemodialysis prescription was changed to maintain the KT/V unchanged. Time was decreased by increasing urea clearance by increasing the QB (400 ml/min in 65 patients, 350 ml/min in 4 patients) and employing the Baxter CF 2308 dialyzer. This produced an increase in urea clearance from 192 ml/min to 256 ml/min, and a decrease in duration of dialysis to 164 min. The CF 2308 dialyzer has an ultrafiltration coefficient of 4 ml/mmHg/hr, which is easily managed without ultrafiltration control equipment. Patients were in the study group for a mean of 176.5 days. The short period of time caused no significant change in blood urea nitrogen, creatinine, potassium, bicarbonate, calcium, phosphorus, hematocrit, or symptomatic hypotension and vomiting. Patient acceptance of the change in hemodialysis time was excellent. Hemodialysis times similar to those reported by others with large experience in shortening hemodialysis time can be achieved in many instances with standard hemodialysis equipment.
Galen
M
M
St. Francis Hospital, Hartford, Connecticut.
D001639:Bicarbonates; D001783:Blood Flow Velocity; D015312:Hemodialysis Solutions; D006440:Hemofiltration / Q000295:instrumentation*; D006801:Humans; D007676:Kidney Failure, Chronic / Q000097:blood / Q000628:therapy*; D007688:Kidneys, Artificial; D006435:Renal Dialysis / Q000379:methods*; D013997:Time Factors; D014508:Urea / Q000097:blood
D001639:Bicarbonates; D015312:Hemodialysis Solutions; D014508:Urea