- 作者：Susana Roca Meroñ ; o ; Rosa Marí ; a de Alarcó ; n Jimé ; nez ; Cristina Jimeno Griñ ; ó ; Mercedes Albadalejo Jimé ; nez ; Elena Zarcos Pedrinaci ; Elena Vaquero Parrizas ; Marí ; a de los Á ; ngeles Garcí ; a Herná ; ndez ; Manuel Molina Nú ; ñ ; ez<sup> ; sup><sup>manuel.molina4@carm.essup>
- 关键词：Hemodiafiltració ; n on-line ; Volumen convectivo ; Kt
- 刊名：Di谩lisis y Trasplante
- 出版年：2012
- 期刊代码：pca116_18862845
- 类别：med
- 出版时间：April-June, 2012
- 卷：33
- 期：2
- 页码：37-41
- 文件大小：245 K
ss="h4">Introduction and objectives
Key elements in the best results that have been reported in on-line hemodiafiltration are the dialysis dose delivered and reinfusion volume. Technological advances allow two forms of automated control of reinfusion volume (a volume-based and a pressure-based control system), and two methods of measuring Kt obtained by ionic dialysance (OCM and Diascan). The purpose of this study was to compare both these control systems.
ss="h4">Methods
We designed a prospective, crossover study of the prevalent population in post-dilution on-line hemodiafiltration, with explicit consent. For 2 consecutive weeks, three sessions were performed with automatic reinfusion according to hematocrit and total protein values and Kt measurement with OCM, and three sessions were performed with automatic reinfusion according to transmembrane pressure and Kt measurement with Diascan. The average reinfusion volume and Kt were compared. Variables were contrasted with Student's t-test for related samples. Statistical significance was set at p <0.05.
ss="h4">Results
Sixteen patients concluded the study (56%men, with a mean age of 58.8 years). A total of 81.3%had autologous or prosthetic fistulas for vascular access. Reinfusion volume was significantly higher (p = 0.029) under pressure control (23.24 卤 2.55 lversus 21.81 卤 1.75 l) while Kt measured by OCM was significantly (p <0.001) higher than that measured by Diascan (59.94 卤 5.05 l versus 55.12 卤 4.15 l).
ss="h4">Conclusions
We found a 6.2%increase in volume reinfusion under pressure control, although both methods performed well in the final convective transport liters. The dialysis dose measured by Kt was higher when OCM was used.