Estudio comparativo en pacientes en Hemodiafiltración en línea postdilucional de alta eficacia con diferentes flujos de líquido dializante, tiempo programado y tiempo real

Abstract

The dialysis dose (DD) is a key element of dialysis adequacy and affects survival of patients undergoing dialysis. Some elements standing out concerning the DD are: dialysis time, blood fl ow rate (Qb), transfer area coeffi cient (KOA) and dialysate fl ow rate (Qd).
The aim of this study is to fi nd out whether Qd 800 ml / min and 240 minutes prescribed time is more effective than Qd 500 ml / min and 240 minutes prescribed time and also to compare Qd 500 ml/min and 240 minutes of real dialysis time.
Patients and Methods
A transversal prospective study was conducted of a population in dialysis, inclusion criteria being an adult treated with post-dilution on-line haemodiafi ltration and suffi cient blood fl ow rate.
In all patients was performed 18 consecutive sessions varying Qd and time as follows:
Stage 1: 6 sessions Qd 800 ml/min and prescribed time 240 minutes (F1)
Stage 2: 6 sessions Qd 500 ml/min and prescribed time 240 minutes (F2)
Stage 3: 6 sessions Qd 500 ml/min and real dialysis time 240 minutes (F3)
Statistical analysis performed using SPSS 13.0 for Windows.
Quantitative variables were expressed as mean, standard deviation and range, and qualitative variables expressed as frequency and percentage.
Results
432 sessions analysed getting higher Kt and reinfusion volume (VTR) in stage 3 in relation to other stages. No signifi cant difference between stage 1 and 2.
Discussion and conclusions:
No differences in dialysis effi cacy Qd 500 ml / min versus Qd 800 ml / min. Nevertheless, increasing 10 minutes in each session, the dialysis dose increases 2.77 litres and VTR increases 9%, halving this way the number of patients that don’t reach 20 litres reinfusion volume. All this achieved with a lower fee due to the size difference bicarbonate concentrate packaging.