Risk of Inadequate Dialysis Dose in Hemodialysis Patients with High Watson Volume. A Warning
Identifieur interne : 000947 ( Istex/Corpus ); précédent : 000946; suivant : 000948Risk of Inadequate Dialysis Dose in Hemodialysis Patients with High Watson Volume. A Warning
Auteurs : S. Cigarrán ; F. Coronel ; J. Torrente ; M. Sevilla ; J. C. D. Bayl NSource :
- Hemodialysis International [ 1492-7535 ] ; 2004-01.
Abstract
Quality control of dialysis treatment has received wide attention since inadequate dialysis dose was an independent risk factor of morbidity and mortality in hemodialysis patients. Each 0.1 decrease in Kt/V less than 1.2 is estimated to increase the relative risk of death by 5–7%. A higher Kt/V can be achieved by increasing treatment time, using a larger dialyzer or increasing blood or dialysate flow rates. The aim of this cross‐sectional study was to know, using online conductivity monitor (OCM) routinely, whether a certain subgroup of patients is being treated inadequately. 24 anuric patients were included in a cross‐sectional study: 20.8% were diabetics, mean age 64.7 ± 18.2 years; 16% females. Access blood were AVFI and the effective dialyzed blood flow was set at 350 mL/min, with recirculation <5%. BMI was 25.4 ± 3.8 kg/m2 and body weight was 69.7 ± 12 kg. All patients were dialyzed thrice weekly (245 ± 21 min) with dialysis machine 4008H (Fresenius Medical Care) equipped with OCM monitor and the hollow fiber high‐flux polysulfone membrane (HF‐80 1.8 m2) and helixone (Fx‐60, 1.6 m2). Dialysate flow was maintained at 500 mL/min, with standard dialysate liquid. Drug therapy was not varied. OCM was validated for our population and reported in other abstracts (r2 = 0.96, p < 0.001). Inadequate dialysis dose was considered at OCM Kt/V less than 1.2. Data were processed and statistically analyzed with SPSS 11.0 software package. Watson volume (Wv) to other baseline characteristics was assessed by using contingency tables, t‐tests, analysis of variance, and linear regression, as appropriate. All the tests were performed for a 0.05 significance level. The OCM Kt/V weekly was inversely related to Wv (r = −0.833, p < 0.001). 20.8% of our patients are at risk of inadequate dialysis dose, and it reflects our current practice of dialysis prescription. All of them are anuric young men with a Wv > 40 L. Specific efforts are required to deliver an adequate dialysis dose in this kind of patients. This can be achieved by altering dialysis frequency, increasing membrane surface, and/or increasing dialysis flow. OCM Kt/V device permits a daily dialysis dose delivery and, consequently, an individualized prescription. Prospective studies are required to establish whether adequate dialysis dose in patients with Wv > 40 L may further improve their survival. Variable n OCM Kt/V Age (year) THD (min) Watson volume (L) OCM Kt/V
<1.2 5 (20.8%) 1.05 ± 0.03* 45.2 ± 12.91* 240 ± 21.21 45.02 ± 3.03* OCM Kt/V
≥1.2 19 (79.2%) 1.36 ± 0.17 69.89 ± 15.9 246 ± 21.21 34.6 ± 4.9 * p < 0.001.
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DOI: 10.1111/j.1492-7535.2004.0085o.x
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<record><TEI wicri:istexFullTextTei="biblStruct"><teiHeader><fileDesc><titleStmt><title xml:lang="en">Risk of Inadequate Dialysis Dose in Hemodialysis Patients with High Watson Volume. A Warning</title><author><name sortKey="Cigarran, S" sort="Cigarran, S" uniqKey="Cigarran S" first="S." last="Cigarrán">S. Cigarrán</name><affiliation><mods:affiliation>Unidad Nefrológica Moncloa, Fresenius Medical Care, Madrid, Spain.</mods:affiliation></affiliation></author><author><name sortKey="Coronel, F" sort="Coronel, F" uniqKey="Coronel F" first="F." last="Coronel">F. Coronel</name><affiliation><mods:affiliation>Unidad Nefrológica Moncloa, Fresenius Medical Care, Madrid, Spain.</mods:affiliation></affiliation></author><author><name sortKey="Torrente, J" sort="Torrente, J" uniqKey="Torrente J" first="J." last="Torrente">J. Torrente</name><affiliation><mods:affiliation>Unidad Nefrológica Moncloa, Fresenius Medical Care, Madrid, Spain.</mods:affiliation></affiliation></author><author><name sortKey="Sevilla, M" sort="Sevilla, M" uniqKey="Sevilla M" first="M." last="Sevilla">M. Sevilla</name><affiliation><mods:affiliation>Unidad Nefrológica Moncloa, Fresenius Medical Care, Madrid, Spain.</mods:affiliation></affiliation></author><author><name sortKey="Bayl N, J C D" sort="Bayl N, J C D" uniqKey="Bayl N J" first="J. C. D." last="Bayl N">J. C. D. Bayl N</name><affiliation><mods:affiliation>Unidad Nefrológica Moncloa, Fresenius Medical Care, Madrid, Spain.</mods:affiliation></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">ISTEX</idno><idno type="RBID">ISTEX:BC71E7CF39CA31872BB55A750BC92B399EA11D91</idno><date when="2004" year="2004">2004</date><idno type="doi">10.1111/j.1492-7535.2004.0085o.x</idno><idno type="url">https://api.istex.fr/ark:/67375/WNG-9LBMLGGV-P/fulltext.pdf</idno><idno type="wicri:Area/Istex/Corpus">000947</idno><idno type="wicri:explorRef" wicri:stream="Istex" wicri:step="Corpus" wicri:corpus="ISTEX">000947</idno></publicationStmt><sourceDesc><biblStruct><analytic><title level="a" type="main">Risk of Inadequate Dialysis Dose in Hemodialysis Patients with High Watson Volume. A Warning</title><author><name sortKey="Cigarran, S" sort="Cigarran, S" uniqKey="Cigarran S" first="S." last="Cigarrán">S. Cigarrán</name><affiliation><mods:affiliation>Unidad Nefrológica Moncloa, Fresenius Medical Care, Madrid, Spain.</mods:affiliation></affiliation></author><author><name sortKey="Coronel, F" sort="Coronel, F" uniqKey="Coronel F" first="F." last="Coronel">F. Coronel</name><affiliation><mods:affiliation>Unidad Nefrológica Moncloa, Fresenius Medical Care, Madrid, Spain.</mods:affiliation></affiliation></author><author><name sortKey="Torrente, J" sort="Torrente, J" uniqKey="Torrente J" first="J." last="Torrente">J. Torrente</name><affiliation><mods:affiliation>Unidad Nefrológica Moncloa, Fresenius Medical Care, Madrid, Spain.</mods:affiliation></affiliation></author><author><name sortKey="Sevilla, M" sort="Sevilla, M" uniqKey="Sevilla M" first="M." last="Sevilla">M. Sevilla</name><affiliation><mods:affiliation>Unidad Nefrológica Moncloa, Fresenius Medical Care, Madrid, Spain.</mods:affiliation></affiliation></author><author><name sortKey="Bayl N, J C D" sort="Bayl N, J C D" uniqKey="Bayl N J" first="J. C. D." last="Bayl N">J. C. D. Bayl N</name><affiliation><mods:affiliation>Unidad Nefrológica Moncloa, Fresenius Medical Care, Madrid, Spain.</mods:affiliation></affiliation></author></analytic><monogr></monogr><series><title level="j" type="main">Hemodialysis International</title><title level="j" type="alt">HEMODIALYSIS INTERNATIONAL</title><idno type="ISSN">1492-7535</idno><idno type="eISSN">1542-4758</idno><imprint><biblScope unit="vol">8</biblScope><biblScope unit="issue">1</biblScope><biblScope unit="page" from="84">84</biblScope><biblScope unit="page" to="84">84</biblScope><biblScope unit="page-count">100</biblScope><publisher>Blackwell Science Inc</publisher><pubPlace>Oxford, UK; Malden, USA</pubPlace><date type="published" when="2004-01">2004-01</date></imprint><idno type="ISSN">1492-7535</idno></series></biblStruct></sourceDesc><seriesStmt><idno type="ISSN">1492-7535</idno></seriesStmt></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">Quality control of dialysis treatment has received wide attention since inadequate dialysis dose was an independent risk factor of morbidity and mortality in hemodialysis patients. Each 0.1 decrease in Kt/V less than 1.2 is estimated to increase the relative risk of death by 5–7%. A higher Kt/V can be achieved by increasing treatment time, using a larger dialyzer or increasing blood or dialysate flow rates. The aim of this cross‐sectional study was to know, using online conductivity monitor (OCM) routinely, whether a certain subgroup of patients is being treated inadequately. 24 anuric patients were included in a cross‐sectional study: 20.8% were diabetics, mean age 64.7 ± 18.2 years; 16% females. Access blood were AVFI and the effective dialyzed blood flow was set at 350 mL/min, with recirculation <5%. BMI was 25.4 ± 3.8 kg/m2 and body weight was 69.7 ± 12 kg. All patients were dialyzed thrice weekly (245 ± 21 min) with dialysis machine 4008H (Fresenius Medical Care) equipped with OCM monitor and the hollow fiber high‐flux polysulfone membrane (HF‐80 1.8 m2) and helixone (Fx‐60, 1.6 m2). Dialysate flow was maintained at 500 mL/min, with standard dialysate liquid. Drug therapy was not varied. OCM was validated for our population and reported in other abstracts (r2 = 0.96, p < 0.001). Inadequate dialysis dose was considered at OCM Kt/V less than 1.2. Data were processed and statistically analyzed with SPSS 11.0 software package. Watson volume (Wv) to other baseline characteristics was assessed by using contingency tables, t‐tests, analysis of variance, and linear regression, as appropriate. All the tests were performed for a 0.05 significance level. The OCM Kt/V weekly was inversely related to Wv (r = −0.833, p < 0.001). 20.8% of our patients are at risk of inadequate dialysis dose, and it reflects our current practice of dialysis prescription. All of them are anuric young men with a Wv > 40 L. Specific efforts are required to deliver an adequate dialysis dose in this kind of patients. This can be achieved by altering dialysis frequency, increasing membrane surface, and/or increasing dialysis flow. OCM Kt/V device permits a daily dialysis dose delivery and, consequently, an individualized prescription. Prospective studies are required to establish whether adequate dialysis dose in patients with Wv > 40 L may further improve their survival. Variable n OCM Kt/V Age (year) THD (min) Watson volume (L) OCM Kt/V
<1.2 5 (20.8%) 1.05 ± 0.03* 45.2 ± 12.91* 240 ± 21.21 45.02 ± 3.03* OCM Kt/V
≥1.2 19 (79.2%) 1.36 ± 0.17 69.89 ± 15.9 246 ± 21.21 34.6 ± 4.9 * p < 0.001.</div></front></TEI><istex><corpusName>wiley</corpusName><keywords><teeft><json:string>hemodialysis</json:string><json:string>international society</json:string><json:string>annual dialysis conference</json:string><json:string>renal</json:string><json:string>nephrology</json:string><json:string>fistula</json:string><json:string>hemodialysis patient</json:string><json:string>dialyzer</json:string><json:string>heparin</json:string><json:string>dialysate</json:string><json:string>datum</json:string><json:string>urea</json:string><json:string>online</json:string><json:string>venous</json:string><json:string>esrd</json:string><json:string>creatinine</json:string><json:string>hemodialysis hemodialysis international</json:string><json:string>pediatric</json:string><json:string>solute</json:string><json:string>nhhd</json:string><json:string>viral</json:string><json:string>serum 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donor</json:string><json:string>tremendous improvement</json:string><json:string>significant independent predictor</json:string><json:string>individual scale</json:string><json:string>general hospital</json:string><json:string>heart failure</json:string><json:string>tesio catheter</json:string><json:string>dialysis catheter</json:string><json:string>average staff time</json:string><json:string>extracorporeal serum</json:string><json:string>urea kinetics</json:string><json:string>body size</json:string><json:string>urea mass</json:string><json:string>dialysis modality</json:string><json:string>initial flow</json:string><json:string>vascular surgeon</json:string><json:string>causative agent</json:string><json:string>precautionary measure</json:string><json:string>peer pressure</json:string><json:string>syndrome</json:string><json:string>ontario</json:string><json:string>albumin</json:string><json:string>clearance</json:string><json:string>mortality</json:string><json:string>complication</json:string><json:string>hemoglobin</json:string><json:string>diabetes</json:string><json:string>infection</json:string></teeft></keywords><author><json:item><name>S. Cigarrán</name><affiliations><json:string>Unidad Nefrológica Moncloa, Fresenius Medical Care, Madrid, Spain.</json:string></affiliations></json:item><json:item><name>F. Coronel</name><affiliations><json:string>Unidad Nefrológica Moncloa, Fresenius Medical Care, Madrid, Spain.</json:string></affiliations></json:item><json:item><name>J. Torrente</name><affiliations><json:string>Unidad Nefrológica Moncloa, Fresenius Medical Care, Madrid, Spain.</json:string></affiliations></json:item><json:item><name>M. Sevilla</name><affiliations><json:string>Unidad Nefrológica Moncloa, Fresenius Medical Care, Madrid, Spain.</json:string></affiliations></json:item><json:item><name>J.C.D. Baylón</name><affiliations><json:string>Unidad Nefrológica Moncloa, Fresenius Medical Care, Madrid, Spain.</json:string></affiliations></json:item></author><articleId><json:string>HDI085O</json:string></articleId><arkIstex>ark:/67375/WNG-9LBMLGGV-P</arkIstex><language><json:string>eng</json:string></language><originalGenre><json:string>abstract</json:string></originalGenre><abstract>Quality control of dialysis treatment has received wide attention since inadequate dialysis dose was an independent risk factor of morbidity and mortality in hemodialysis patients. Each 0.1 decrease in Kt/V less than 1.2 is estimated to increase the relative risk of death by 5–7%. A higher Kt/V can be achieved by increasing treatment time, using a larger dialyzer or increasing blood or dialysate flow rates. The aim of this cross‐sectional study was to know, using online conductivity monitor (OCM) routinely, whether a certain subgroup of patients is being treated inadequately. 24 anuric patients were included in a cross‐sectional study: 20.8% were diabetics, mean age 64.7 ± 18.2 years; 16% females. Access blood were AVFI and the effective dialyzed blood flow was set at 350 mL/min, with recirculation >5%. BMI was 25.4 ± 3.8 kg/m2 and body weight was 69.7 ± 12 kg. All patients were dialyzed thrice weekly (245 ± 21 min) with dialysis machine 4008H (Fresenius Medical Care) equipped with OCM monitor and the hollow fiber high‐flux polysulfone membrane (HF‐80 1.8 m2) and helixone (Fx‐60, 1.6 m2). Dialysate flow was maintained at 500 mL/min, with standard dialysate liquid. Drug therapy was not varied. OCM was validated for our population and reported in other abstracts (r2 = 0.96, p > 0.001). Inadequate dialysis dose was considered at OCM Kt/V less than 1.2. Data were processed and statistically analyzed with SPSS 11.0 software package. Watson volume (Wv) to other baseline characteristics was assessed by using contingency tables, t‐tests, analysis of variance, and linear regression, as appropriate. All the tests were performed for a 0.05 significance level. The OCM Kt/V weekly was inversely related to Wv (r = −0.833, p > 0.001). 20.8% of our patients are at risk of inadequate dialysis dose, and it reflects our current practice of dialysis prescription. All of them are anuric young men with a Wv > 40 L. Specific efforts are required to deliver an adequate dialysis dose in this kind of patients. This can be achieved by altering dialysis frequency, increasing membrane surface, and/or increasing dialysis flow. OCM Kt/V device permits a daily dialysis dose delivery and, consequently, an individualized prescription. Prospective studies are required to establish whether adequate dialysis dose in patients with Wv > 40 L may further improve their survival. Variable n OCM Kt/V Age (year) THD (min) Watson volume (L) OCM Kt/V >1.2 5 (20.8%) 1.05 ± 0.03* 45.2 ± 12.91* 240 ± 21.21 45.02 ± 3.03* OCM Kt/V ≥1.2 19 (79.2%) 1.36 ± 0.17 69.89 ± 15.9 246 ± 21.21 34.6 ± 4.9 * p > 0.001.</abstract><qualityIndicators><score>10</score><pdfWordCount>24342</pdfWordCount><pdfCharCount>151874</pdfCharCount><pdfVersion>1.4</pdfVersion><pdfPageCount>33</pdfPageCount><pdfPageSize>595 x 782 pts</pdfPageSize><pdfWordsPerPage>738</pdfWordsPerPage><pdfText>true</pdfText><refBibsNative>false</refBibsNative><abstractWordCount>381</abstractWordCount><abstractCharCount>2606</abstractCharCount><keywordCount>0</keywordCount></qualityIndicators><title>Risk of Inadequate Dialysis Dose in Hemodialysis Patients with High Watson Volume. A Warning</title><genre><json:string>abstract</json:string></genre><host><title>Hemodialysis International</title><language><json:string>unknown</json:string></language><doi><json:string>10.1111/(ISSN)1542-4758</json:string></doi><issn><json:string>1492-7535</json:string></issn><eissn><json:string>1542-4758</json:string></eissn><publisherId><json:string>HDI</json:string></publisherId><volume>8</volume><issue>1</issue><pages><first>84</first><last>84</last><total>100</total></pages><genre><json:string>journal</json:string></genre></host><namedEntities><unitex><date><json:string>8/1/03</json:string><json:string>2/8/03</json:string><json:string>between May 2002 and September 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A Warning</title><title level="a" type="short">24th Annual Dialysis Conference: Abstracts</title></titleStmt><publicationStmt><authority>ISTEX</authority><publisher>Blackwell Science Inc</publisher><pubPlace>Oxford, UK; Malden, USA</pubPlace><date type="published" when="2004-01"></date></publicationStmt><notesStmt><note type="content-type" subtype="abstract" source="abstract" scheme="https://content-type.data.istex.fr/ark:/67375/XTP-HPN7T1Q2-R">abstract</note><note type="publication-type" subtype="journal" scheme="https://publication-type.data.istex.fr/ark:/67375/JMC-0GLKJH51-B">journal</note></notesStmt><sourceDesc><biblStruct type="abstract"><analytic><title level="a" type="main">Risk of Inadequate Dialysis Dose in Hemodialysis Patients with High Watson Volume. A Warning</title><title level="a" type="short">24th Annual Dialysis Conference: Abstracts</title><author xml:id="author-0000"><persName><forename type="first">S.</forename><surname>Cigarrán</surname></persName><affiliation><address><addrLine>Unidad Nefrológica Moncloa</addrLine><addrLine>Fresenius Medical Care, Madrid, Spain.</addrLine><country key="ES" xml:lang="en">SPAIN</country></address></affiliation></author><author xml:id="author-0001"><persName><forename type="first">F.</forename><surname>Coronel</surname></persName><affiliation><address><addrLine>Unidad Nefrológica Moncloa</addrLine><addrLine>Fresenius Medical Care, Madrid, Spain.</addrLine><country key="ES" xml:lang="en">SPAIN</country></address></affiliation></author><author xml:id="author-0002"><persName><forename type="first">J.</forename><surname>Torrente</surname></persName><affiliation><address><addrLine>Unidad Nefrológica Moncloa</addrLine><addrLine>Fresenius Medical Care, Madrid, Spain.</addrLine><country key="ES" xml:lang="en">SPAIN</country></address></affiliation></author><author xml:id="author-0003"><persName><forename type="first">M.</forename><surname>Sevilla</surname></persName><affiliation><address><addrLine>Unidad Nefrológica Moncloa</addrLine><addrLine>Fresenius Medical Care, Madrid, Spain.</addrLine><country key="ES" xml:lang="en">SPAIN</country></address></affiliation></author><author xml:id="author-0004"><persName><forename type="first">J.C.D.</forename><surname>Baylón</surname></persName><affiliation><address><addrLine>Unidad Nefrológica Moncloa</addrLine><addrLine>Fresenius Medical Care, Madrid, Spain.</addrLine><country key="ES" xml:lang="en">SPAIN</country></address></affiliation></author><idno type="istex">BC71E7CF39CA31872BB55A750BC92B399EA11D91</idno><idno type="ark">ark:/67375/WNG-9LBMLGGV-P</idno><idno type="DOI">10.1111/j.1492-7535.2004.0085o.x</idno><idno type="unit">HDI085O</idno><idno type="toTypesetVersion">file:HDI.HDI085O.pdf</idno></analytic><monogr><title level="j" type="main">Hemodialysis International</title><title level="j" type="alt">HEMODIALYSIS INTERNATIONAL</title><idno type="pISSN">1492-7535</idno><idno type="eISSN">1542-4758</idno><idno type="book-DOI">10.1111/(ISSN)1542-4758</idno><idno type="book-part-DOI">10.1111/hdi.2004.8.issue-1</idno><idno type="product">HDI</idno><idno type="publisherDivision">ST</idno><imprint><biblScope unit="vol">8</biblScope><biblScope unit="issue">1</biblScope><biblScope unit="page" from="84">84</biblScope><biblScope unit="page" to="84">84</biblScope><biblScope unit="page-count">100</biblScope><publisher>Blackwell Science Inc</publisher><pubPlace>Oxford, UK; Malden, USA</pubPlace><date type="published" when="2004-01"></date></imprint></monogr></biblStruct></sourceDesc></fileDesc><encodingDesc><schemaRef type="ODD" url="https://xml-schema.delivery.istex.fr/tei-istex.odd"></schemaRef><appInfo><application ident="pub2tei" version="1.0.10" when="2019-12-20"><label>pub2TEI-ISTEX</label><desc>A set of style sheets for converting XML documents encoded in various scientific publisher formats into a common TEI format.
<ref target="http://www.tei-c.org/">We use TEI</ref></desc></application></appInfo></encodingDesc><profileDesc><abstract xml:lang="en" style="main"><p>Quality control of dialysis treatment has received wide attention since inadequate dialysis dose was an independent risk factor of morbidity and mortality in hemodialysis patients. Each 0.1 decrease in Kt/V less than 1.2 is estimated to increase the relative risk of death by 5–7%. A higher Kt/V can be achieved by increasing treatment time, using a larger dialyzer or increasing blood or dialysate flow rates. The aim of this cross‐sectional study was to know, using online conductivity monitor (OCM) routinely, whether a certain subgroup of patients is being treated inadequately. 24 anuric patients were included in a cross‐sectional study: 20.8% were diabetics, mean age 64.7 ± 18.2 years; 16% females. Access blood were AVFI and the effective dialyzed blood flow was set at 350 mL/min, with recirculation <5%. BMI was 25.4 ± 3.8 kg/m<hi rend="superscript">2</hi> and body weight was 69.7 ± 12 kg. All patients were dialyzed thrice weekly (245 ± 21 min) with dialysis machine 4008H (Fresenius Medical Care) equipped with OCM monitor and the hollow fiber high‐flux polysulfone membrane (HF‐80 1.8 m<hi rend="superscript">2</hi>) and helixone (Fx‐60, 1.6 m<hi rend="superscript">2</hi>). Dialysate flow was maintained at 500 mL/min, with standard dialysate liquid. Drug therapy was not varied. OCM was validated for our population and reported in other abstracts (r<hi rend="superscript">2</hi> = 0.96, p < 0.001). Inadequate dialysis dose was considered at OCM Kt/V less than 1.2. Data were processed and statistically analyzed with SPSS 11.0 software package. Watson volume (W<hi rend="subscript">v</hi>) to other baseline characteristics was assessed by using contingency tables, t‐tests, analysis of variance, and linear regression, as appropriate. All the tests were performed for a 0.05 significance level. The OCM Kt/V weekly was inversely related to W<hi rend="subscript">v</hi> (r = −0.833, p < 0.001). 20.8% of our patients are at risk of inadequate dialysis dose, and it reflects our current practice of dialysis prescription. All of them are anuric young men with a W<hi rend="subscript">v</hi> > 40 L. Specific efforts are required to deliver an adequate dialysis dose in this kind of patients. This can be achieved by altering dialysis frequency, increasing membrane surface, and/or increasing dialysis flow. OCM Kt/V device permits a daily dialysis dose delivery and, consequently, an individualized prescription. Prospective studies are required to establish whether adequate dialysis dose in patients with W<hi rend="subscript">v</hi> > 40 L may further improve their survival.
<graphic url="image_n/HDI_085o_fu1.gif" rend="inline image"></graphic><table cols="6"><row role="label"><cell>Variable</cell><cell>n</cell><cell>OCM Kt/V</cell><cell>Age (year)</cell><cell>THD (min)</cell><cell>Watson volume (L)</cell></row><row><cell>OCM Kt/V
<1.2</cell><cell>5 (20.8%)</cell><cell>1.05 ± 0.03<hi><ref type="note" target="#tu5n1">*</ref></hi></cell><cell>45.2 ± 12.91<hi><ref type="note" target="#tu5n1">*</ref></hi></cell><cell>240 ± 21.21</cell><cell>45.02 ± 3.03<hi><ref type="note" target="#tu5n1">*</ref></hi></cell></row><row><cell>OCM Kt/V
≥1.2</cell><cell>19 (79.2%)</cell><cell>1.36 ± 0.17</cell><cell>69.89 ± 15.9</cell><cell>246 ± 21.21</cell><cell>34.6 ± 4.9</cell></row></table></p></abstract><textClass><keywords rend="tocHeading1"><term>Hemodialysis Abstracts from the 24th Annual Dialysis Conference</term></keywords></textClass><langUsage><language ident="en"></language></langUsage></profileDesc><revisionDesc><change when="2019-12-20" who="#istex" xml:id="pub2tei">formatting</change></revisionDesc></teiHeader></istex:fulltextTEI><json:item><extension>txt</extension><original>false</original><mimetype>text/plain</mimetype><uri>https://api.istex.fr/ark:/67375/WNG-9LBMLGGV-P/fulltext.txt</uri></json:item></fulltext><metadata><istex:metadataXml wicri:clean="Wiley component found"><istex:xmlDeclaration>version="1.0" encoding="UTF-8" standalone="yes"</istex:xmlDeclaration><istex:document><component version="2.0" type="serialArticle" xml:lang="en"><header><publicationMeta level="product"><publisherInfo><publisherName>Blackwell Science Inc</publisherName><publisherLoc>Oxford, UK; Malden, USA</publisherLoc></publisherInfo><doi origin="wiley" registered="yes">10.1111/(ISSN)1542-4758</doi><issn type="print">1492-7535</issn><issn type="electronic">1542-4758</issn><idGroup><id type="product" value="HDI"></id><id type="publisherDivision" value="ST"></id></idGroup><titleGroup><title type="main" sort="HEMODIALYSIS INTERNATIONAL">Hemodialysis International</title></titleGroup></publicationMeta><publicationMeta level="part" position="01001"><doi origin="wiley">10.1111/hdi.2004.8.issue-1</doi><numberingGroup><numbering type="journalVolume" number="8">8</numbering><numbering type="journalIssue" number="1">1</numbering></numberingGroup><coverDate startDate="2004-01">January 2004</coverDate></publicationMeta><publicationMeta level="unit" type="abstract" position="0008400" status="forIssue"><doi origin="wiley">10.1111/j.1492-7535.2004.0085o.x</doi><idGroup><id type="unit" value="HDI085O"></id></idGroup><countGroup><count type="pageTotal" number="100"></count></countGroup><titleGroup><title type="tocHeading1">Hemodialysis Abstracts from the 24th Annual Dialysis Conference</title></titleGroup><eventGroup><event type="firstOnline" date="2004-01-23"></event><event type="publishedOnlineFinalForm" date="2004-01-23"></event><event type="xmlConverted" agent="Converter:BPG_TO_WML3G version:2.3.15 mode:FullText source:Header result:Header" date="2010-07-19"></event><event type="xmlConverted" agent="Converter:WILEY_ML3G_TO_WILEY_ML3GV2 version:3.8.8" date="2014-01-26"></event><event type="xmlConverted" agent="Converter:WML3G_To_WML3G version:4.1.7 mode:FullText,remove_FC" date="2014-10-24"></event></eventGroup><numberingGroup><numbering type="pageFirst" number="84">84</numbering><numbering type="pageLast" number="84">84</numbering></numberingGroup><linkGroup><link type="toTypesetVersion" href="file:HDI.HDI085O.pdf"></link></linkGroup></publicationMeta><contentMeta><countGroup><count type="figureTotal" number="1"></count><count type="tableTotal" number="1"></count><count type="formulaTotal" number="0"></count><count type="referenceTotal" number="0"></count><count type="wordTotal" number="0"></count><count type="linksPubMed" number="0"></count><count type="linksCrossRef" number="0"></count></countGroup><titleGroup><title type="main">Risk of Inadequate Dialysis Dose in Hemodialysis Patients with High Watson Volume. A Warning</title><title type="shortAuthors">24th Annual Dialysis Conference: Abstracts</title><title type="short">24th Annual Dialysis Conference: Abstracts</title></titleGroup><creators><creator creatorRole="author" xml:id="cr1" affiliationRef="#a7-3"><personName><givenNames>S.</givenNames><familyName>Cigarrán</familyName></personName></creator><creator creatorRole="author" xml:id="cr2" affiliationRef="#a7-3"><personName><givenNames>F.</givenNames><familyName>Coronel</familyName></personName></creator><creator creatorRole="author" xml:id="cr3" affiliationRef="#a7-3"><personName><givenNames>J.</givenNames><familyName>Torrente</familyName></personName></creator><creator creatorRole="author" xml:id="cr4" affiliationRef="#a7-3"><personName><givenNames>M.</givenNames><familyName>Sevilla</familyName></personName></creator><creator creatorRole="author" xml:id="cr5" affiliationRef="#a7-3"><personName><givenNames>J.C.D.</givenNames><familyName>Baylón</familyName></personName></creator></creators><affiliationGroup><affiliation xml:id="a7-3" countryCode="ES"><unparsedAffiliation>Unidad Nefrológica Moncloa, Fresenius Medical Care, Madrid, Spain.</unparsedAffiliation></affiliation></affiliationGroup><abstractGroup><abstract type="main" xml:lang="en"><p>Quality control of dialysis treatment has received wide attention since inadequate dialysis dose was an independent risk factor of morbidity and mortality in hemodialysis patients. Each 0.1 decrease in Kt/V less than 1.2 is estimated to increase the relative risk of death by 5–7%. A higher Kt/V can be achieved by increasing treatment time, using a larger dialyzer or increasing blood or dialysate flow rates. The aim of this cross‐sectional study was to know, using online conductivity monitor (OCM) routinely, whether a certain subgroup of patients is being treated inadequately. 24 anuric patients were included in a cross‐sectional study: 20.8% were diabetics, mean age 64.7 ± 18.2 years; 16% females. Access blood were AVFI and the effective dialyzed blood flow was set at 350 mL/min, with recirculation <5%. BMI was 25.4 ± 3.8 kg/m<sup>2</sup> and body weight was 69.7 ± 12 kg. All patients were dialyzed thrice weekly (245 ± 21 min) with dialysis machine 4008H (Fresenius Medical Care) equipped with OCM monitor and the hollow fiber high‐flux polysulfone membrane (HF‐80 1.8 m<sup>2</sup>) and helixone (Fx‐60, 1.6 m<sup>2</sup>). Dialysate flow was maintained at 500 mL/min, with standard dialysate liquid. Drug therapy was not varied. OCM was validated for our population and reported in other abstracts (r<sup>2</sup> = 0.96, p < 0.001). Inadequate dialysis dose was considered at OCM Kt/V less than 1.2. Data were processed and statistically analyzed with SPSS 11.0 software package. Watson volume (W<sub>v</sub>) to other baseline characteristics was assessed by using contingency tables, t‐tests, analysis of variance, and linear regression, as appropriate. All the tests were performed for a 0.05 significance level. The OCM Kt/V weekly was inversely related to W<sub>v</sub> (r = −0.833, p < 0.001). 20.8% of our patients are at risk of inadequate dialysis dose, and it reflects our current practice of dialysis prescription. All of them are anuric young men with a W<sub>v</sub> > 40 L. Specific efforts are required to deliver an adequate dialysis dose in this kind of patients. This can be achieved by altering dialysis frequency, increasing membrane surface, and/or increasing dialysis flow. OCM Kt/V device permits a daily dialysis dose delivery and, consequently, an individualized prescription. Prospective studies are required to establish whether adequate dialysis dose in patients with W<sub>v</sub> > 40 L may further improve their survival.
<inlineGraphic alt="inline image" location="image_n/HDI_085o_fu1.gif" href=""></inlineGraphic><tabularFixed><table frame="topbot"><tgroup cols="6" align="left"><colspec colnum="1" colname="col1" align="left"></colspec><colspec colnum="2" colname="col2" align="char" char="."></colspec><colspec colnum="3" colname="col3" align="char" char="."></colspec><colspec colnum="4" colname="col4" align="char" char="."></colspec><colspec colnum="5" colname="col5" align="char" char="."></colspec><thead valign="bottom"><row rowsep="1"><entry>Variable</entry><entry>n</entry><entry>OCM Kt/V</entry><entry>Age (year)</entry><entry>THD (min)</entry><entry>Watson volume (L)</entry></row></thead><tbody valign="top"><row><entry>OCM Kt/V
<1.2</entry><entry>5 (20.8%)</entry><entry>1.05 ± 0.03<link href="#tu5n1">*</link></entry><entry>45.2 ± 12.91<link href="#tu5n1">*</link></entry><entry>240 ± 21.21</entry><entry>45.02 ± 3.03<link href="#tu5n1">*</link></entry></row><row><entry>OCM Kt/V
≥1.2</entry><entry>19 (79.2%)</entry><entry>1.36 ± 0.17</entry><entry>69.89 ± 15.9</entry><entry>246 ± 21.21</entry><entry>34.6 ± 4.9</entry></row></tbody></tgroup></table><noteGroup><note xml:id="tu5n1"><label>*</label><p>p < 0.001.</p></note></noteGroup></tabularFixed> </p></abstract></abstractGroup></contentMeta></header></component></istex:document></istex:metadataXml><mods version="3.6"><titleInfo lang="en"><title>Risk of Inadequate Dialysis Dose in Hemodialysis Patients with High Watson Volume. A Warning</title></titleInfo><titleInfo type="abbreviated" lang="en"><title>24th Annual Dialysis Conference: Abstracts</title></titleInfo><titleInfo type="alternative" contentType="CDATA" lang="en"><title>Risk of Inadequate Dialysis Dose in Hemodialysis Patients with High Watson Volume. A Warning</title></titleInfo><name type="personal"><namePart type="given">S.</namePart><namePart type="family">Cigarrán</namePart><affiliation>Unidad Nefrológica Moncloa, Fresenius Medical Care, Madrid, Spain.</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">F.</namePart><namePart type="family">Coronel</namePart><affiliation>Unidad Nefrológica Moncloa, Fresenius Medical Care, Madrid, Spain.</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">J.</namePart><namePart type="family">Torrente</namePart><affiliation>Unidad Nefrológica Moncloa, Fresenius Medical Care, Madrid, Spain.</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">M.</namePart><namePart type="family">Sevilla</namePart><affiliation>Unidad Nefrológica Moncloa, Fresenius Medical Care, Madrid, Spain.</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">J.C.D.</namePart><namePart type="family">Baylón</namePart><affiliation>Unidad Nefrológica Moncloa, Fresenius Medical Care, Madrid, Spain.</affiliation><role><roleTerm type="text">author</roleTerm></role></name><typeOfResource>text</typeOfResource><genre type="abstract" displayLabel="abstract" authority="ISTEX" authorityURI="https://content-type.data.istex.fr" valueURI="https://content-type.data.istex.fr/ark:/67375/XTP-HPN7T1Q2-R">abstract</genre><originInfo><publisher>Blackwell Science Inc</publisher><place><placeTerm type="text">Oxford, UK; Malden, USA</placeTerm></place><dateIssued encoding="w3cdtf">2004-01</dateIssued><copyrightDate encoding="w3cdtf">2004</copyrightDate></originInfo><language><languageTerm type="code" authority="rfc3066">en</languageTerm><languageTerm type="code" authority="iso639-2b">eng</languageTerm></language><physicalDescription><extent unit="figures">1</extent><extent unit="tables">1</extent><extent unit="formulas">0</extent><extent unit="references">0</extent><extent unit="linksCrossRef">0</extent><extent unit="words">0</extent></physicalDescription><abstract lang="en">Quality control of dialysis treatment has received wide attention since inadequate dialysis dose was an independent risk factor of morbidity and mortality in hemodialysis patients. Each 0.1 decrease in Kt/V less than 1.2 is estimated to increase the relative risk of death by 5–7%. A higher Kt/V can be achieved by increasing treatment time, using a larger dialyzer or increasing blood or dialysate flow rates. The aim of this cross‐sectional study was to know, using online conductivity monitor (OCM) routinely, whether a certain subgroup of patients is being treated inadequately. 24 anuric patients were included in a cross‐sectional study: 20.8% were diabetics, mean age 64.7 ± 18.2 years; 16% females. Access blood were AVFI and the effective dialyzed blood flow was set at 350 mL/min, with recirculation <5%. BMI was 25.4 ± 3.8 kg/m2 and body weight was 69.7 ± 12 kg. All patients were dialyzed thrice weekly (245 ± 21 min) with dialysis machine 4008H (Fresenius Medical Care) equipped with OCM monitor and the hollow fiber high‐flux polysulfone membrane (HF‐80 1.8 m2) and helixone (Fx‐60, 1.6 m2). Dialysate flow was maintained at 500 mL/min, with standard dialysate liquid. Drug therapy was not varied. OCM was validated for our population and reported in other abstracts (r2 = 0.96, p < 0.001). Inadequate dialysis dose was considered at OCM Kt/V less than 1.2. Data were processed and statistically analyzed with SPSS 11.0 software package. Watson volume (Wv) to other baseline characteristics was assessed by using contingency tables, t‐tests, analysis of variance, and linear regression, as appropriate. All the tests were performed for a 0.05 significance level. The OCM Kt/V weekly was inversely related to Wv (r = −0.833, p < 0.001). 20.8% of our patients are at risk of inadequate dialysis dose, and it reflects our current practice of dialysis prescription. All of them are anuric young men with a Wv > 40 L. Specific efforts are required to deliver an adequate dialysis dose in this kind of patients. This can be achieved by altering dialysis frequency, increasing membrane surface, and/or increasing dialysis flow. OCM Kt/V device permits a daily dialysis dose delivery and, consequently, an individualized prescription. Prospective studies are required to establish whether adequate dialysis dose in patients with Wv > 40 L may further improve their survival. Variable n OCM Kt/V Age (year) THD (min) Watson volume (L) OCM Kt/V
<1.2 5 (20.8%) 1.05 ± 0.03* 45.2 ± 12.91* 240 ± 21.21 45.02 ± 3.03* OCM Kt/V
≥1.2 19 (79.2%) 1.36 ± 0.17 69.89 ± 15.9 246 ± 21.21 34.6 ± 4.9 * p < 0.001.</abstract><relatedItem type="host"><titleInfo><title>Hemodialysis International</title></titleInfo><genre type="journal" authority="ISTEX" authorityURI="https://publication-type.data.istex.fr" valueURI="https://publication-type.data.istex.fr/ark:/67375/JMC-0GLKJH51-B">journal</genre><identifier type="ISSN">1492-7535</identifier><identifier type="eISSN">1542-4758</identifier><identifier type="DOI">10.1111/(ISSN)1542-4758</identifier><identifier type="PublisherID">HDI</identifier><part><date>2004</date><detail type="volume"><caption>vol.</caption><number>8</number></detail><detail type="issue"><caption>no.</caption><number>1</number></detail><extent unit="pages"><start>84</start><end>84</end><total>100</total></extent></part></relatedItem><identifier type="istex">BC71E7CF39CA31872BB55A750BC92B399EA11D91</identifier><identifier type="ark">ark:/67375/WNG-9LBMLGGV-P</identifier><identifier type="DOI">10.1111/j.1492-7535.2004.0085o.x</identifier><identifier type="ArticleID">HDI085O</identifier><accessCondition type="use and reproduction" contentType="copyright">© Wiley. All rights reserved.</accessCondition><recordInfo><recordContentSource authority="ISTEX" authorityURI="https://loaded-corpus.data.istex.fr" valueURI="https://loaded-corpus.data.istex.fr/ark:/67375/XBH-L0C46X92-X">wiley</recordContentSource><recordOrigin>Converted from (version ) to MODS version 3.6.</recordOrigin><recordCreationDate encoding="w3cdtf">2019-11-14</recordCreationDate></recordInfo></mods><json:item><extension>json</extension><original>false</original><mimetype>application/json</mimetype><uri>https://api.istex.fr/ark:/67375/WNG-9LBMLGGV-P/record.json</uri></json:item></metadata><serie></serie></istex></record>Pour manipuler ce document sous Unix (Dilib)
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