Accelerated hemodialysis: a new safe and simple method of a high filter-low patient blood flow rate hemodialysis.
Accelerated hemodialysis (AHD) is a new safe method of hemodialysis that is done using accelerated hemodialysis blood lines (registered). These lines allow partial controlled recirculation of blood through a recirculation segment. AHD allows increase in the filter blood flow without increasing the patient blood flow and thus allows the use of larger filters of higher efficiency, and provides a high blood flow in most parts of the dialysis circuit to permit heparin free dialysis. On the other hand, the patient blood flow can be decreased without increasing the filter blood flow and allows safe sessions for low body weight patients and those with hemodynamic instability or inefficient vascular assess. Twenty-five hemodialysis sessions were conducted with an adolescent girl, 13 years old, 30 kg body weight, on a chronic hemodialysis program. The sessions included: five double-needle hemodialysis sessions (DNHD) with a pediatric filter at a rate of 130 mL/min; five accelerated hemodialysis sessions (AHD) using the same filter at a rate of (65 + 65) mL/min and another five sessions at rate of (130 + 130) mL/min; five (DNHD) were done using an adult hemodialysis filter rate of 130 mL/min; and five (AHD) using the same filter at a rate of (130 + 130) mL/min. In all sessions pre- and post-dialysis levels of BUN and creatinine were measured and post/predialysis ratios were calculated. In AHD the BUN and creatinine level in the patient, and filter segments of the arterial line and in the recirculation segment were measured and the actual patient blood flow was calculated. The efficiency of AHD was decreased by decreasing the actual patient blood flow (p < 0.05) but was not increased by increasing the filter blood flow in both pediatric and adult filters (p > 0.05). There were no significant changes between the intended patient blood flow rate and the actual patient blood flow as calculated from BUN and creatinine levels. The AHD is a simple safe and applicable mode of hemodialysis that needs further studies to verify factors affecting its efficiency and to approve its clinical applications.
Mohamad
E H
EH
Pediatric Nephrology Department, New Children Hospital, Cairo University, Egypt.
D000293:Adolescent; D001783:Blood Flow Velocity; D001806:Blood Urea Nitrogen; D003404:Creatinine / Q000097:blood; D004867:Equipment Design; D005069:Evaluation Studies as Topic; D005260:Female; D005374:Filtration / Q000295:instrumentation / Q000379:methods; D006801:Humans; D007676:Kidney Failure, Chronic / Q000097:blood / Q000503:physiopathology / Q000628:therapy; D006435:Renal Dialysis / Q000295:instrumentation / Q000379:methods* / Q000706:statistics & numerical data
D003404:Creatinine