On-line clearance monitoring for blood access management.
On-line Clearance Monitoring (OCM) provides frequent and precise information about urea clearance values during haemodialysis. In the case of blood access recirculation, it is presumed that urea clearance values on OCM would be lower and suspect to blood access malfunction. In order to check the relation between significantly lower urea clearance values and blood access recirculation, the Kt value (Clearance x time/min) for fifteen patients on OCM, including the patients with a low Kt/V in spite of their small urea distribution volume (V) was observed. Average urea clearance was calculated indirectly using Kt value (Kt/time in minutes = average clearance ml/min) and blood access recirculation tests performed using slow/stop flow two-needle, three samples method (urea method). After comparison of the recirculation percentage to clearance value, positive correlation between high recirculation and clearance reduction was noted. OCM alongside detection of haemodialysis inefficiency is also a practical instrument for blood access management between regular monitoring. Lower OCM urea clearance values demonstrate a possible blood access problem that can be confirmed with another method. When an OCM urea clearance reading is decreased by more than 25%, undiscovered access recirculation can be suspected.
Mehmedović
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University Clinical Center Tuzla, Dialysis Department, Tuzla, Bosnia and Herzegovina. amra87@bih.net.ba
D001166:Arteriovenous Shunt, Surgical; D006801:Humans; D009862:Online Systems; D006435:Renal Dialysis; D014508:Urea / Q000097:blood*
D014508:Urea