Abstract

ALBALATE RAMON, Marta et al. What is the optimum dialysate flow in post-dilution online haemodiafiltration?. Nefrología (Madr.) [online]. 2015, vol.35, n.6, pp.533-538. ISSN 1989-2284.  https://dx.doi.org/10.1016/j.nefro.2015.04.007.

Introduction: In post-dilution online hemodiafiltration (OL-HDF), the only recommendation concerning the dialysate, or dialysis fluid, refers to its purity. No study has yet determined whether using a high dialysate flow (Qd) is useful for increasing Kt or ultrafiltration-infusion volume. Objective: Study the influence of Qd on Kt and on infusion volume in OL-HDF. Material and methods: This was a prospective crossover study. There were 37 patients to whom 6 sessions of OL-HDF were administered at 3 different Qds: 500, 600 and 700 ml/min. A 5008^® monitor was used for the dialysis in 21 patients, while an AK-200^® was used in 17. The dialysers used were: 20 with FX 800^® and 17 with Polyflux-210^®. The rest of the parameters were kept constant. Monitor data collected were effective blood flow, effective dialysis time, final Kt and infused volume. Results: We found that using a Qd of 600 or 700 ml/min increased Kt by 1.7% compared to using a Qd of 500 ml/min. Differences in infusion volume were not significant. Increasing Qd from 500 ml/min to 600 and 700 ml/min increased dialysate consumption by 20% and 40%, respectively. Conclusions: With the monitors and dialysers currently used in OL-HDF, a Qd higher than 500 ml/min is unhelpful for increasing the efficacy of Kt or infusion volume. Consequently, using a high Qd wastes water, a truly important resource both from the ecological and economic points of view.

Keywords : Dialysate flow rate; Kt; Hemodiafiltration on-line; Infusion volume.

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