Dialysis Dose Parameters. How Much We Can Improve Them in Our Clinical Practice? Role of Online Conductivity Monitor
Identifieur interne : 000973 ( Istex/Corpus ); précédent : 000972; suivant : 000974Dialysis Dose Parameters. How Much We Can Improve Them in Our Clinical Practice? Role of Online Conductivity Monitor
Auteurs : S. Cigarrán ; F. Coronel ; J. Torrente ; M. Sevilla ; J. C. D. Bayl NSource :
- Hemodialysis International [ 1492-7535 ] ; 2004-01.
Abstract
The mortality and morbidity of hemodialysis patients is, to a large extent, determined by demographics and by existing comorbidities, but it is obvious that variations in dialysis dose have substantial effects. Using eKt/V, 1.2 monthly comparisons are recommended by European guidelines, but they assume that dose is maintained during all monthly sessions. Because of dialysis‐related problems like hypotension, reduction of blood flow, dialysis time, microclotting of the dialyzer, and vascular access problems, the delivered dose may vary from session to session. New developed devices based on online conductivity clearance reflect the electrolyte clearance and, thus, clearance of urea. The aim of this prospective study was to show the variability of dialysis dose. 24 anuric patients were studied during 3 months: 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 online conductivity monitor (OCM) and the hollow fiber high‐flux polysulfone membrane (HF‐80 1.8 m2) and helixone (Fx‐60, 1.6 m2). OCM was validated for our population and reported in other abstracts (r2 = 0.96, p < 0.001). Dialysate flow was maintained at 500 mL/min, with standard dialysate liquid. Each patient was subjected to OCM on regular sessions during 3 months, and blood Kt/V samples were taken on midweek day, once a month. Data were processed and statistically analyzed with SPSS 11.0 software package. Kt/V OCM relation with 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 conductivity‐based OCM provides an accurate tool to monitor the dose and control of each hemodialysis session and adds to the efficiency of current dialysis adequacy monitoring. OCM device requires little maintenance, and no extra effort is needed. Monthly Kt/V does not reflect the variability of each session. Further studies are necessary to evaluate its influence on morbidity and mortality.
Descriptives
Variables Minimum Maximum Mean SD Age (year) 31 86 64.75 18.243 Membrane surface 1.6 1.8 1.675 0.0989 Interdialysis weight gain 500 4200 2266.67 1016.673 BMI 18.22 31.03 25.4155 3.83630 Time on dialysis (min) 210 320 245.21 21.340 OCM 0.990 1.880 1.29921 0.201072 dPVV/Kt/V (Daugirdas) 1.00 2.09 1.4067 0.21924 Watson volume (L) 25.8 49.3 36.833 6.3095
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DOI: 10.1111/j.1492-7535.2004.0085n.x
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<record><TEI wicri:istexFullTextTei="biblStruct"><teiHeader><fileDesc><titleStmt><title xml:lang="en">Dialysis Dose Parameters. How Much We Can Improve Them in Our Clinical Practice? Role of Online Conductivity Monitor</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:51C9B6E885AA9BF596BC9D8755B6068FB21133BB</idno><date when="2004" year="2004">2004</date><idno type="doi">10.1111/j.1492-7535.2004.0085n.x</idno><idno type="url">https://api.istex.fr/ark:/67375/WNG-XXXTBC28-8/fulltext.pdf</idno><idno type="wicri:Area/Istex/Corpus">000973</idno><idno type="wicri:explorRef" wicri:stream="Istex" wicri:step="Corpus" wicri:corpus="ISTEX">000973</idno></publicationStmt><sourceDesc><biblStruct><analytic><title level="a" type="main">Dialysis Dose Parameters. How Much We Can Improve Them in Our Clinical Practice? Role of Online Conductivity Monitor</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="83">83</biblScope><biblScope unit="page" to="83">83</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">The mortality and morbidity of hemodialysis patients is, to a large extent, determined by demographics and by existing comorbidities, but it is obvious that variations in dialysis dose have substantial effects. Using eKt/V, 1.2 monthly comparisons are recommended by European guidelines, but they assume that dose is maintained during all monthly sessions. Because of dialysis‐related problems like hypotension, reduction of blood flow, dialysis time, microclotting of the dialyzer, and vascular access problems, the delivered dose may vary from session to session. New developed devices based on online conductivity clearance reflect the electrolyte clearance and, thus, clearance of urea. The aim of this prospective study was to show the variability of dialysis dose. 24 anuric patients were studied during 3 months: 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 online conductivity monitor (OCM) and the hollow fiber high‐flux polysulfone membrane (HF‐80 1.8 m2) and helixone (Fx‐60, 1.6 m2). OCM was validated for our population and reported in other abstracts (r2 = 0.96, p < 0.001). Dialysate flow was maintained at 500 mL/min, with standard dialysate liquid. Each patient was subjected to OCM on regular sessions during 3 months, and blood Kt/V samples were taken on midweek day, once a month. Data were processed and statistically analyzed with SPSS 11.0 software package. Kt/V OCM relation with 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 conductivity‐based OCM provides an accurate tool to monitor the dose and control of each hemodialysis session and adds to the efficiency of current dialysis adequacy monitoring. OCM device requires little maintenance, and no extra effort is needed. Monthly Kt/V does not reflect the variability of each session. Further studies are necessary to evaluate its influence on morbidity and mortality.
Descriptives
Variables Minimum Maximum Mean SD Age (year) 31 86 64.75 18.243 Membrane surface 1.6 1.8 1.675 0.0989 Interdialysis weight gain 500 4200 2266.67 1016.673 BMI 18.22 31.03 25.4155 3.83630 Time on dialysis (min) 210 320 245.21 21.340 OCM 0.990 1.880 1.29921 0.201072 dPVV/Kt/V (Daugirdas) 1.00 2.09 1.4067 0.21924 Watson volume (L) 25.8 49.3 36.833 6.3095</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 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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>HDI085N</json:string></articleId><arkIstex>ark:/67375/WNG-XXXTBC28-8</arkIstex><language><json:string>eng</json:string></language><originalGenre><json:string>abstract</json:string></originalGenre><abstract>The mortality and morbidity of hemodialysis patients is, to a large extent, determined by demographics and by existing comorbidities, but it is obvious that variations in dialysis dose have substantial effects. Using eKt/V, 1.2 monthly comparisons are recommended by European guidelines, but they assume that dose is maintained during all monthly sessions. Because of dialysis‐related problems like hypotension, reduction of blood flow, dialysis time, microclotting of the dialyzer, and vascular access problems, the delivered dose may vary from session to session. New developed devices based on online conductivity clearance reflect the electrolyte clearance and, thus, clearance of urea. The aim of this prospective study was to show the variability of dialysis dose. 24 anuric patients were studied during 3 months: 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 online conductivity monitor (OCM) and the hollow fiber high‐flux polysulfone membrane (HF‐80 1.8 m2) and helixone (Fx‐60, 1.6 m2). OCM was validated for our population and reported in other abstracts (r2 = 0.96, p > 0.001). Dialysate flow was maintained at 500 mL/min, with standard dialysate liquid. Each patient was subjected to OCM on regular sessions during 3 months, and blood Kt/V samples were taken on midweek day, once a month. Data were processed and statistically analyzed with SPSS 11.0 software package. Kt/V OCM relation with 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 conductivity‐based OCM provides an accurate tool to monitor the dose and control of each hemodialysis session and adds to the efficiency of current dialysis adequacy monitoring. OCM device requires little maintenance, and no extra effort is needed. Monthly Kt/V does not reflect the variability of each session. Further studies are necessary to evaluate its influence on morbidity and mortality. Descriptives Variables Minimum Maximum Mean SD Age (year) 31 86 64.75 18.243 Membrane surface 1.6 1.8 1.675 0.0989 Interdialysis weight gain 500 4200 2266.67 1016.673 BMI 18.22 31.03 25.4155 3.83630 Time on dialysis (min) 210 320 245.21 21.340 OCM 0.990 1.880 1.29921 0.201072 dPVV/Kt/V (Daugirdas) 1.00 2.09 1.4067 0.21924 Watson volume (L) 25.8 49.3 36.833 6.3095</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>395</abstractWordCount><abstractCharCount>2685</abstractCharCount><keywordCount>0</keywordCount></qualityIndicators><title>Dialysis Dose Parameters. How Much We Can Improve Them in Our Clinical Practice? Role of Online Conductivity Monitor</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>83</first><last>83</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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How Much We Can Improve Them in Our Clinical Practice? Role of Online Conductivity Monitor</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">Dialysis Dose Parameters. How Much We Can Improve Them in Our Clinical Practice? Role of Online Conductivity Monitor</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">51C9B6E885AA9BF596BC9D8755B6068FB21133BB</idno><idno type="ark">ark:/67375/WNG-XXXTBC28-8</idno><idno type="DOI">10.1111/j.1492-7535.2004.0085n.x</idno><idno type="unit">HDI085N</idno><idno type="toTypesetVersion">file:HDI.HDI085N.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="83">83</biblScope><biblScope unit="page" to="83">83</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.
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<hi rend="bold"> Descriptives </hi>
<table cols="5"><row role="label"><cell>Variables</cell><cell>Minimum</cell><cell>Maximum</cell><cell>Mean</cell><cell>SD</cell></row><row><cell>Age (year)</cell><cell>31</cell><cell>86</cell><cell>64.75</cell><cell>18.243</cell></row><row><cell>Membrane surface</cell><cell>1.6</cell><cell>1.8</cell><cell> 1.675</cell><cell>0.0989</cell></row><row><cell>Interdialysis weight gain</cell><cell>500</cell><cell>4200</cell><cell>2266.67</cell><cell>1016.673</cell></row><row><cell>BMI</cell><cell>18.22</cell><cell>31.03</cell><cell>25.4155</cell><cell>3.83630</cell></row><row><cell>Time on dialysis (min)</cell><cell>210</cell><cell>320</cell><cell>245.21</cell><cell>21.340</cell></row><row><cell>OCM</cell><cell>0.990</cell><cell>1.880</cell><cell>1.29921</cell><cell>0.201072</cell></row><row><cell>dPVV/Kt/V (Daugirdas)</cell><cell>1.00</cell><cell>2.09</cell><cell>1.4067</cell><cell>0.21924</cell></row><row><cell>Watson volume (L)</cell><cell>25.8</cell><cell>49.3</cell><cell>36.833</cell><cell>6.3095</cell></row></table></p><p><graphic url="image_n/HDI_085n_fu1.gif" rend="inline image"></graphic></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-XXXTBC28-8/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="0008300" status="forIssue"><doi origin="wiley">10.1111/j.1492-7535.2004.0085n.x</doi><idGroup><id type="unit" value="HDI085N"></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="83">83</numbering><numbering type="pageLast" number="83">83</numbering></numberingGroup><linkGroup><link type="toTypesetVersion" href="file:HDI.HDI085N.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">Dialysis Dose Parameters. How Much We Can Improve Them in Our Clinical Practice? Role of Online Conductivity Monitor</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="#a7-2"><personName><givenNames>S.</givenNames><familyName>Cigarrán</familyName></personName></creator><creator creatorRole="author" xml:id="cr2" affiliationRef="#a7-2"><personName><givenNames>F.</givenNames><familyName>Coronel</familyName></personName></creator><creator creatorRole="author" xml:id="cr3" affiliationRef="#a7-2"><personName><givenNames>J.</givenNames><familyName>Torrente</familyName></personName></creator><creator creatorRole="author" xml:id="cr4" affiliationRef="#a7-2"><personName><givenNames>M.</givenNames><familyName>Sevilla</familyName></personName></creator><creator creatorRole="author" xml:id="cr5" affiliationRef="#a7-2"><personName><givenNames>J.C.D.</givenNames><familyName>Baylón</familyName></personName></creator></creators><affiliationGroup><affiliation xml:id="a7-2" countryCode="ES"><unparsedAffiliation>Unidad Nefrológica Moncloa, Fresenius Medical Care, Madrid, Spain.</unparsedAffiliation></affiliation></affiliationGroup><abstractGroup><abstract type="main" xml:lang="en"><p>The mortality and morbidity of hemodialysis patients is, to a large extent, determined by demographics and by existing comorbidities, but it is obvious that variations in dialysis dose have substantial effects. Using eKt/V, 1.2 monthly comparisons are recommended by European guidelines, but they assume that dose is maintained during all monthly sessions. Because of dialysis‐related problems like hypotension, reduction of blood flow, dialysis time, microclotting of the dialyzer, and vascular access problems, the delivered dose may vary from session to session. New developed devices based on online conductivity clearance reflect the electrolyte clearance and, thus, clearance of urea. The aim of this prospective study was to show the variability of dialysis dose. 24 anuric patients were studied during 3 months: 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 online conductivity monitor (OCM) 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>). OCM was validated for our population and reported in other abstracts (r<sup>2</sup> = 0.96, p < 0.001). Dialysate flow was maintained at 500 mL/min, with standard dialysate liquid. Each patient was subjected to OCM on regular sessions during 3 months, and blood Kt/V samples were taken on midweek day, once a month. Data were processed and statistically analyzed with SPSS 11.0 software package. Kt/V OCM relation with 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 conductivity‐based OCM provides an accurate tool to monitor the dose and control of each hemodialysis session and adds to the efficiency of current dialysis adequacy monitoring. OCM device requires little maintenance, and no extra effort is needed. Monthly Kt/V does not reflect the variability of each session. Further studies are necessary to evaluate its influence on morbidity and mortality.</p><p>
<b> Descriptives </b>
<tabularFixed><table frame="topbot"><tgroup cols="5" 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>Variables</entry><entry>Minimum</entry><entry>Maximum</entry><entry>Mean</entry><entry>SD</entry></row></thead><tbody valign="top"><row><entry>Age (year)</entry><entry>31</entry><entry>86</entry><entry>64.75</entry><entry>18.243</entry></row><row><entry>Membrane surface</entry><entry>1.6</entry><entry>1.8</entry><entry> 1.675</entry><entry>0.0989</entry></row><row><entry>Interdialysis weight gain</entry><entry>500</entry><entry>4200</entry><entry>2266.67</entry><entry>1016.673</entry></row><row><entry>BMI</entry><entry>18.22</entry><entry>31.03</entry><entry>25.4155</entry><entry>3.83630</entry></row><row><entry>Time on dialysis (min)</entry><entry>210</entry><entry>320</entry><entry>245.21</entry><entry>21.340</entry></row><row><entry>OCM</entry><entry>0.990</entry><entry>1.880</entry><entry>1.29921</entry><entry>0.201072</entry></row><row><entry>dPVV/Kt/V (Daugirdas)</entry><entry>1.00</entry><entry>2.09</entry><entry>1.4067</entry><entry>0.21924</entry></row><row><entry>Watson volume (L)</entry><entry>25.8</entry><entry>49.3</entry><entry>36.833</entry><entry>6.3095</entry></row></tbody></tgroup></table></tabularFixed> </p><p><inlineGraphic alt="inline image" location="image_n/HDI_085n_fu1.gif" href=""></inlineGraphic></p></abstract></abstractGroup></contentMeta></header></component></istex:document></istex:metadataXml><mods version="3.6"><titleInfo lang="en"><title>Dialysis Dose Parameters. How Much We Can Improve Them in Our Clinical Practice? Role of Online Conductivity Monitor</title></titleInfo><titleInfo type="abbreviated" lang="en"><title>24th Annual Dialysis Conference: Abstracts</title></titleInfo><titleInfo type="alternative" contentType="CDATA" lang="en"><title>Dialysis Dose Parameters. How Much We Can Improve Them in Our Clinical Practice? Role of Online Conductivity Monitor</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">The mortality and morbidity of hemodialysis patients is, to a large extent, determined by demographics and by existing comorbidities, but it is obvious that variations in dialysis dose have substantial effects. Using eKt/V, 1.2 monthly comparisons are recommended by European guidelines, but they assume that dose is maintained during all monthly sessions. Because of dialysis‐related problems like hypotension, reduction of blood flow, dialysis time, microclotting of the dialyzer, and vascular access problems, the delivered dose may vary from session to session. New developed devices based on online conductivity clearance reflect the electrolyte clearance and, thus, clearance of urea. The aim of this prospective study was to show the variability of dialysis dose. 24 anuric patients were studied during 3 months: 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 online conductivity monitor (OCM) and the hollow fiber high‐flux polysulfone membrane (HF‐80 1.8 m2) and helixone (Fx‐60, 1.6 m2). OCM was validated for our population and reported in other abstracts (r2 = 0.96, p < 0.001). Dialysate flow was maintained at 500 mL/min, with standard dialysate liquid. Each patient was subjected to OCM on regular sessions during 3 months, and blood Kt/V samples were taken on midweek day, once a month. Data were processed and statistically analyzed with SPSS 11.0 software package. Kt/V OCM relation with 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 conductivity‐based OCM provides an accurate tool to monitor the dose and control of each hemodialysis session and adds to the efficiency of current dialysis adequacy monitoring. OCM device requires little maintenance, and no extra effort is needed. Monthly Kt/V does not reflect the variability of each session. Further studies are necessary to evaluate its influence on morbidity and mortality.
Descriptives
Variables Minimum Maximum Mean SD Age (year) 31 86 64.75 18.243 Membrane surface 1.6 1.8 1.675 0.0989 Interdialysis weight gain 500 4200 2266.67 1016.673 BMI 18.22 31.03 25.4155 3.83630 Time on dialysis (min) 210 320 245.21 21.340 OCM 0.990 1.880 1.29921 0.201072 dPVV/Kt/V (Daugirdas) 1.00 2.09 1.4067 0.21924 Watson volume (L) 25.8 49.3 36.833 6.3095</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>83</start><end>83</end><total>100</total></extent></part></relatedItem><identifier type="istex">51C9B6E885AA9BF596BC9D8755B6068FB21133BB</identifier><identifier type="ark">ark:/67375/WNG-XXXTBC28-8</identifier><identifier type="DOI">10.1111/j.1492-7535.2004.0085n.x</identifier><identifier type="ArticleID">HDI085N</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-XXXTBC28-8/record.json</uri></json:item></metadata><serie></serie></istex></record>Pour manipuler ce document sous Unix (Dilib)
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