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Slow Extended Nocturnal Home Hemodialysis Shows Superior Adequacy Compared to In-Center Dialysis: A Mathematical Analysis.
MedLine Citation:
PMID:  23095806     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
Extended nocturnal home hemodialysis has gained renewed interest. However, no removal data for single/double needle (lumen) (SL and DL, respectively) or for low/high blood flow in extended dialysis are available. Therefore, we studied dialysis adequacy in different nocturnal home hemodialysis strategies. Coupling a kinetic with a dialyzer model, we calculated a reduction ratio from pre- to post-dialysis (RR) and total solute removal (TSR) of urea, methylguanidine (MG), β(2)-microglobulin, and phosphate. Simulations were done for dialysis with blood flow Q(b)350 ml/min (DL-4h), extended DL high flow with Q(b)350 (DL-HF-8h) and low flow with Q(b)175 (DL-LF-8h), and SL with Q(b)273 (SL-8h). Compared to DL-4h, TSR was 28-59% larger for DL-HF-8h. TSR was most increased for β(2)-microglobulin (18%) with DL-LF-8h, and for MG (35%) with SL-8h. Furthermore, RRs were equal (DL-LF-8h), higher (SL-8h), and even more increased (DL-HF-8h) for all studied solutes. In the home setting, DL-LF-8h and SL-8h are safe and promising strategies.
Authors:
Koen Van Canneyt; Sunny Eloot; Raymond Vanholder; Patrick Segers; Pascal Verdonck; Wim Van Biesen
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-10-18
Journal Detail:
Title:  Blood purification     Volume:  34     ISSN:  1421-9735     ISO Abbreviation:  Blood Purif.     Publication Date:  2012 Oct 
Date Detail:
Created Date:  2012-10-25     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8402040     Medline TA:  Blood Purif     Country:  -    
Other Details:
Languages:  ENG     Pagination:  219-224     Citation Subset:  -    
Copyright Information:
Copyright © 2012 S. Karger AG, Basel.
Affiliation:
Institute Biomedical Technology (IBiTech-bioMMeda), Ghent University, Ghent, Belgium.
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