title: Measurement of vascular access flow by online clearance monitor in online hemodiafiltration.
abstract: BACKGROUND
  Measurement of ionic dialysance has been shown to accurately determine urea dialyzer clearance and vascular access flow rate (Qa) in diffusive hemodialysis. Recently, online clearance monitoring (OCM) in an online hemodiafiltration (OL-HDF) machine could accurately measure urea dialyzer clearance. In the present study, OCM was utilized to assess the Qa in OL-HDF.
  
  
  METHODS
  In 32 stable end-stage renal disease patients undergoing predilution OL-HDF, the values of Qa measured by the OCM technique (Qa(OCMT)) in a Fresenius 4008H HDF machine were compared with those determined by the standard ultrasound dilution technique (Qa(UDT)).
  
  
  RESULTS
  The values of Qa(UDT) and Qa(OCMT) measured at the beginning of the HDF session were 800.5 ± 910.3 and 794.6 ± 895.4 ml/min (nonsignificant). There was a significant correlation between the two techniques (r = 0.95, p < 0.01). A Bland-Altman plot demonstrated a good agreement.
  
  
  CONCLUSIONS
  The vascular access flow determined by OCM, which is integrated mostly in the current HDF machine, is highly accurate, easy to perform, and economical and can be used for vascular access surveillance in OL-HDF.
authors.affiliation: Division of Nephrology, Department of Medicine, Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Bangkok, Thailand.
authors.forename: Khajohn
authors.initials: K
authors.lastname: Tiranathanagul
authors.forename: Paweena
authors.initials: P
authors.lastname: Susantitaphong
authors.forename: Piyaporn
authors.initials: P
authors.lastname: Towannang
authors.forename: Patcharin
authors.initials: P
authors.lastname: Injan
authors.forename: Kearkiat
authors.initials: K
authors.lastname: Praditpornsilpa
authors.forename: Somchai
authors.initials: S
authors.lastname: Eiam-Ong
mesh_terms: D001783:Blood Flow Velocity; D002408:Catheters, Indwelling; D017583:Hemodiafiltration / Q000295:instrumentation* / Q000379:methods*; D006801:Humans; D014508:Urea
chemical_list: D014508:Urea