| Patient- and treatment-related determinants of convective volume in post-dilution haemodiafiltration in clinical practice. | |
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MedLine Citation:
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PMID: 19515802 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: Large convective volumes are recommended for online haemodiafiltration (HDF) to maximize solute removal. There has been little systematic evaluation of factors that determine convective volumes in routine clinical practice. METHODS: In the present study, potential patient- and treatment-related determinants of convective volume were analysed in 235 consecutive patients on post-dilution HDF using multivariable linear regression models. All patients (age 64 +/- 14 years; 61% male) participated in the ongoing CONvective TRAnsport STudy (CONTRAST). Additionally, differences in convective volumes between dialysers were evaluated. RESULTS: The mean convective volume was 19.4 +/- 4.0 L (+/-SD) per treatment, with a large variation between the participating centres (centre means ranging from 13.4 +/- 0.9 L to 24.5 +/- 0.12 L, +/- SE). The mean filtration fraction of the blood flow was 25.9 +/- 3.6. In the multivariable analysis, factors that were significantly related to convective volume were haematocrit [inversely, regression coefficient (B) = -1.4 +/- 0.4 L per 10%], serum albumin (positively, B = 1.0 +/- 0.4 L per 10 g/L), blood flow rate (positively, B = 0.4 +/- 0.04 L per 10 mL/min) and treatment time (positively, B = 5.1 +/- 0.4 L/h). In addition, significant differences between dialysers were observed, likely explained by different operational conditions. CONCLUSIONS: Apart from increasing the treatment time and blood flow rate, convective volumes could be optimized by increasing the filtration fraction in each individual, provided that transmembrane pressures are well within safe limits. The precise role of dialyser characteristics on maximal achievable convective volumes in clinical practice is a topic for further research. |
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Authors:
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E Lars Penne; Neelke C van der Weerd; Michiel L Bots; Marinus A van den Dorpel; Muriel P C Grooteman; Ren??e L??vesque; Menso J Nub??; Piet M Ter Wee; Peter J Blankestijn; |
Publication Detail:
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Type: Journal Article; Research Support, Non-U.S. Gov't Date: 2009-06-10 |
Journal Detail:
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Title: Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association Volume: 24 ISSN: 1460-2385 ISO Abbreviation: Nephrol. Dial. Transplant. Publication Date: 2009 Nov |
Date Detail:
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Created Date: 2009-10-16 Completed Date: 2010-01-07 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 8706402 Medline TA: Nephrol Dial Transplant Country: England |
Other Details:
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Languages: eng Pagination: 3493-9 Citation Subset: IM |
Affiliation:
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Department of Nephrology, University Medical Center Utrecht, Utrecht, The Netherlands. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adult Aged Convection Female Filtration Hematocrit Hemodiafiltration* Humans Male Middle Aged Serum Albumin / analysis |
| Chemical | |
Reg. No./Substance:
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0/Serum Albumin |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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