Abstract: FR-PO825

In-Vitro Dialysis Clearances Using Dharma, the EasyDial Portable Hemodialysis Machine

Session Information

Category: Dialysis

  • 601 Standard Hemodialysis for ESRD

Authors

  • Mcnamara, Timothy R., EasyDial, Irvine, California, United States
  • Khawar, Osman S., Balboa Nephrology Medical Group, Escondido, California, United States
  • Foster, Sarah L, EasyDial, Irvine, California, United States
Background


Dharma is a unique, fully portable dialysis machine, which uses only 5 Liters of dialysate during each treatment. To determine the efficacy of Dharma in clearing blood waste products, in-vitro dialysis tests were run utilizing bovine blood.

Methods


Twenty-three treatments were conducted and all met the defined parameters of an effective dialysis over 90 – 120 minutes. A common protocol was utilized. Amendments were made for differences between studies inclusive blood flow rates, dialysate, reinfusion solutions and rates.
Dharma machines were prepared with consumables (dialyzer, blood and dialysis circuit cassettes, blood and dialysate lines) and primed. Five liters of dialysate were added to a reservoir and warmed to 37 degrees centigrade. Five liters of bovine blood was spiked with urea, creatinine, potassium, calcium, magnesium and glucose to levels commonly found in dialysis patients. The blood was added to a vessel connected to the arterial line through a 16-gauge needle or a 10 French catheter. Treatments were run by dialysis technicians. Serum samples for waste products were collected at baseline, every 15 minutes and at the end of dialysis. Dialysate pH and conductivity were monitored.

Results

Desired clearances of waste products was achieved at all timepoints (Table 1). Mean clearances were: BUN 77.1% (126.3 mg/dL (±26.4) to 28.93 mg/dL(±6.89), creatinine clearance 88.9% (15.9 mg/dL (±4.2) to 1.76 mg/dL (±0.89) and urea clearance was of 77.5% (225.5mmol (±47.2) to 50.74 mmol (±19.03). Clearances for waste products were greater than 70% at all timepoints and were greatest in the 120-minute treatment group for BUN (78.6%), creatinine (89.5%) and urea (78.7%).

Conclusion


These results verify in-vitro efficacy of Dharma in dialysis treatments. Dharma offers the unique features of portability (18 lbs.), no fixed water connection (5 L dialysate) and the possibility for significantly reducing dialysis treatment times. These features may allow for improving the quality of life and reducing the burden of illness in ESRD patients on dialysis.

BUN, Creatinine and Urea Clearances
 Overall efficacy (n=23)Clearance
%
90 minute efficacy (n=6)Clearance
%
120 minute efficacy (n=17)Clearance
%
 Baseline / End of Treatment Baseline / End of Treatment Baseline / End of TreatmentClearance %
BUN (mg/dL)126.3 (+/- 26.4)
28.93 (+/- 6.89)
77.09%101.5 (+/- 15.86)
26.3 (+/- 15.8)
79%133.06(+/-6.89)
15.97 (+/-0.89)
78.06%
Creatinine (mg/dL)15.9 (+/- 4.2)
1.76 (+/- 0.89)
88.9%12.51 (+/-4.68)
1.96 (+/- 0.86)
87.7%15.97(+/-4.12)
1.67 (+/- 0.89)
89.54%
Urea (mmol)225.5 (+/- 47.2)
50.74 (+/- 19.3)
77.5%181.23 (+/- 23)
44.04 (+/- 30.05)
75.7%236.76 (+/-16.46)
50.31 (+/-12.3)
78.73%

Funding

  • Commercial Support