Measurement of the delivery of dialysis in acute renal failure

James A. Evanson, T. Alp Ikizler, Rebecca Wingard, Stephanie Knights, Yu Shyr, Gerald Schulman, Jonathan Himmelfarb, Raymond M. Hakim

研究成果: Article

85 引文 斯高帕斯(Scopus)

摘要

Background. Recent studies in patients with acute renal failure (ARF) have shown a relationship between the delivered dose of dialysis and patient survival. However, there is currently no consensus on the appropriate method to measure the dose of dialysis in ARF patients. In this study, the dose of dialysis was measured by blood- and dialysate-based kinetic methods in a group of ARF patients who required intermittent hemodialysis. Methods. Treatments were performed using a Fresenius 2008E volumetric hemodialysis machine with the ability to fractionally collect the spent dialysate. Single- , double-pool, and equilibrated Kt/V were determined from the pre-, immediate post-, and 30-minute post-blood urea nitrogen (BUN) measurements. The solute reduction index was determined from the collected dialysate, as well as the single- and double-pool Kt/V. Results. Forty-six treatments in 28 consecutive patients were analyzed. The mean prescribed Kt/V (1.11 ± 0.32) was significantly greater than the delivered dose estimated by single-pool (0.96 ± 0.33), equilibrated (0.84 ± 0.28), and double-pool (0.84 ± 0.30) Kt/V (compared with prescribed, each P < 0.001). There was no statistical differences between the equilibrated and double-pool Kt/V (P = NS). The solute removal index, as determined from the dialysate, corresponded to a Kt/V of 0.56 ± 0.27 and was significantly lower than the single-pool and double-pool Kt/V (each P < 0.001). Conclusion. Blood-based kinetics used to estimate the dose of dialysis in ARF patients on intermittent hemodialysis provide internally consistent results. However, when compared with dialysate- side kinetics, blood-based kinetics substantially overestimated the amount of solute (urea) removal.

原文English
頁(從 - 到)1501-1508
頁數8
期刊Kidney international
55
發行號4
DOIs
出版狀態Published - 1999 一月 1

    指紋

All Science Journal Classification (ASJC) codes

  • Nephrology

引用此

Evanson, J. A., Ikizler, T. A., Wingard, R., Knights, S., Shyr, Y., Schulman, G., Himmelfarb, J., & Hakim, R. M. (1999). Measurement of the delivery of dialysis in acute renal failure. Kidney international, 55(4), 1501-1508. https://doi.org/10.1046/j.1523-1755.1999.00355.x