Accuracy of Online Conductivity Monitor Compared with Daugirdas (dPVV/Kt/V) Model. Use in the Clinical Field
Abstract:The influence of dialysis prescription on outcome is well established. Hemodialysis dose has been shown to have a distinct impact upon the morbidity and mortality rate in patients on regular treatment therapy. Hence, adequacy of dialysis should be guaranteed. New devices based in online conductivity measures have been developed to achieve an adequate dialysis dose. The aim of this study was to compare online conductivity monitor (OCM) with dialysis dose standard methods (Daugirdas Kt/V). 24 anuric patients were included in a cross-sectional study: 20.8% were diabetics, mean age 64.7 ± 18.2 years; 16% females. Access blood were AVFi and the effective dialyzed blood flow was set at 350 mL/min, with recirculation <5%. BMI was 25.4 ± 3.8 kg/m2 and body weight was 69.7 ± 12 kg. All patients were dialyzed thrice weekly (245 ± 21 min) with dialysis machine 4008H (Fresenius Medical Care) equipped with OCM monitor and the hollow fiber high-flux polysulfone membrane (HF-80 1.8 m2) and helixone (Fx-60, 1.6 m2). Dialysate flow was maintained at 500 mL/min, with standard dialysate liquid. Drug therapy was not varied. Each patient was subjected to OCM on midweek day, during 3 consecutive weeks on the same day that blood Kt/V samples were taken as well. Each patient got 3 OCM measurements and Kt/V samples. Data were processed and statistically analyzed with SPSS 11.0 software package. Kt/V OCM relation to other baseline characteristics was assessed by using contingency tables, t-tests, analysis of variance, and linear regression, as appropriate. All the tests were performed for a 0.05 significance level.
The OCM option correlates well with Daugirdas Kt/V obtained from blood samples, in 96.2%, and provides a safe and accurate tool for hemodialysis, adding efficiency to dialysis adequacy monitoring in clinical practice. Also, OCM allows for an individualized dialysis dose. Furthers studies are required to evaluate its influence on patients' evolution.
Document Type: Research Article
Affiliations: Unidad Nefrológica Moncloa, Fresenius Medical Care, Madrid, Spain.
Publication date: January 1, 2004