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Abstract: FR-PO736

Comparison of Measured and Prescribed Dialysate Sodium in Three Brands of Dialysate Acid Concentrate

Session Information

Category: Dialysis

  • 701 Dialysis: Hemodialysis and Frequent Dialysis

Authors

  • Gul, Ambreen, Dialysis Clinic, Inc., Albuqerque, New Mexico, United States
  • Miskulin, Dana, Tufts Medical Center, Boston, Massachusetts, United States
  • Cumber, Serena, Dialysis Clinic, Inc., Albuquerque, New Mexico, United States
  • Paine, S., Dialysis Clinic, Inc., Albuqerque, New Mexico, United States
  • Trujillo, N., Dialysis Clinic, Inc., Albuqerque, New Mexico, United States
  • Anaya, Joseph J., Dialysis Clinic, Inc., Albuquerque, New Mexico, United States
  • Jiang, Huan, Dialysis Clinic, Inc., Albuqerque, New Mexico, United States
  • Zager, Philip, Dialysis Clinic, Inc., Albuqerque, New Mexico, United States
Background

There is ongoing controversy regarding the optimal dialysate sodium concentration (DNa). This issue is further complicated by differences between prescribed and measured DNa. These differences are higher in facilities utilizing Fresenius K2 dialysate delivery machines, dialysate concentrates mixed on site, and a centralized delivery system. These differences may reflect errors in the DNa acid dialysate concentrate, abnormal pressures in the distribution loop, or machine malfunction. The present study was conducted to assess the measured DNa in three brands of dialysate acid concentrate.

Methods

We measured DNa in two lots of Diasol, NaturaLyte and Rockwell acid concentrates, delivered from individual jugs by Fresenius T-machines. We used a single lot of pre-mixed bicarbonate concentrate. The prescribed DNa was 140 mEq/L. We sampled acid concentrates on a single day. We measured DNa on three consecutive days by both direct and indirect ion selective electrode method. We computed least square means of measured DNa concentrations from linear mixed models.

Results

The least square mean DNa concentrations are shown in the Table. There were no statistically significant differences between prescribed and measured DNa observed with different brands of dialysate acid concentrates, measurement method, lot and day of measurements (p=0.3 for each).

Conclusion

There were no significant differences between the prescribed and measured DNa in any of the three pre-mixed dialysate acid concentrates. The significant differences between prescribed and measured DNa previously reported may reflect errors in mixing dialysate concentrates on-site or pressure abnormalities in the delivery loop.

Least square means (95% CI) of measured DNa with prescribed DNa of 140mEq/L
 Indirect ISE (n=18 samples each)Direct ISE (n=18 samples each)
Diasol139.7 (136.9, 142.4)139.3 (136.6, 142.1)
NaturaLyte141.1 (138.3, 143.8)140.4 (137.7, 143.2)
Rockwell140.5 (137.8, 143.2)138.3 (135.6, 141.1)

Funding

  • Clinical Revenue Support