Document Detail


Accuracy and safety of online clearance monitoring based on conductivity variation.
MedLine Citation:
PMID:  11328916     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Haemodialysis dose has been shown to have a distinct impact upon the morbidity and mortality rate in patients on regular dialysis therapy. Accordingly, the adequacy of dialysis treatment should be guaranteed. METHODS: In 200 dialysis sessions two or three +/-10% dialysate conductivity variations were applied to test patient compliance and the accuracy of an electrolyte based online clearance measurement (OCM) reflecting the total clearance of urea. RESULTS: Using a step profile the electrolytic clearance showed highly significant correlation with the reference data in the blood side (n=118, r=0.867, P<0.001) and dialysate side (n=118, r=0.820, P<0.001) if only reference values were taken into account for which the error in mass balance did not exceed 5%. Kt/V according to the single pool model (n=35, r=0.940, P<0.001), the equilibrated single pool variable volume kinetic model (n=36, r=0.982, P<0.001), Daugirdas formula (n=34, r=0.951, P<0.001) and direct quantification of dialysance via spent dialysate (n=26, r=0.900, P<0.001) showed outstanding correlations with electrolyte-based Kt/V at mass balance error below 5%. No adverse clinical effect of OCM was reported. Serum sodium, body weight, heart rate and breathing rate at rest, arterial pO(2) and pCO(2) and blood pressure before haemodialysis remained unaffected in OCM measurements in comparison with baseline parameters. A small influx of sodium (1.53+/-7.62 mmol) into the patient was seen following the impulse, but no signs associated with fluid overload were observed during the study period of 10 consecutive dialysis sessions. CONCLUSIONS: The OCM option of the haemodialysis machine provides a safe and accurate tool for continuous online monitoring of total urea clearance.
Authors:
U Kuhlmann; R Goldau; N Samadi; T Graf; M Gross; G Orlandini; H Lange
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Publication Detail:
Type:  Evaluation Studies; Journal Article    
Journal Detail:
Title:  Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association     Volume:  16     ISSN:  0931-0509     ISO Abbreviation:  Nephrol. Dial. Transplant.     Publication Date:  2001 May 
Date Detail:
Created Date:  2001-04-30     Completed Date:  2001-07-05     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  8706402     Medline TA:  Nephrol Dial Transplant     Country:  England    
Other Details:
Languages:  eng     Pagination:  1053-8     Citation Subset:  IM    
Affiliation:
Centre of Internal Medicine, Clinic of Nephrology, Philipps-University of Marburg, Baldingerstr., D-35033 Marburg, Germany.
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Electrolytes / blood
Female
Humans
Male
Middle Aged
Monitoring, Physiologic / methods*,  standards*
Renal Dialysis*
Safety
Therapy, Computer-Assisted / standards*
Treatment Outcome
Urea / blood*
Chemical
Reg. No./Substance:
0/Electrolytes; 57-13-6/Urea

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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