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Abstract: SA-PO982

How to Reduce the Costs of Hemodialysis Treatment in Low-Income Countries

Session Information

Category: Dialysis

  • 701 Dialysis: Hemodialysis and Frequent Dialysis

Author

  • Touam, Malik, Necker Hospital, Paris, France

Group or Team Name

  • Association RAMM-Paris-France
Background

We aimed to design a low-cost (∼5000 €) dialysis monitor (LCDM) to increase access to hemodialysis (HD) in low-income countries.

Methods

LCDM is a hermetic tank with a volume of 64 l. The dialysate circulates in a closed circuit and in a single pass without mixing between the fresh dialysate and the spent dialysate. The experimental simulation setup was: 4-hour HD session; 70 kg body weight; variable dialysate flow rates (QD); blood flow rate (QB) of 300 ml/min; FX 100® dialyser; dialysate as a solution of NaCl at 155 mmol/l; "blood" as a solution of NaCl + 30 mmol/ urea l + 996 μmol/l creatinine ; ultrafiltrate flow (UF) controlled by a 1% resolution pump. Samples from the inputs and outputs of the dialyzer were taken simultaneously by two operators.

Results

Table 1 shows the quality of the removal of urea and creatinine with a QB of 300 ml/min and a QD of 250 ml/min for twelve sessions of 4 hours. Table 2 shows the result of several ultrafiltration tests and the significant absence of deviation between the prescribed volume and that obtained. LCDM device meets dialysis standards and UF control equivalent to the performance of conventional HD monitors, and also reduces water consumption by around 50%. .

Conclusion

LCDM is an original low cost HD monitor which paves the way to an industrial prototype. This device, along with the reuse of dialyzers/extracorporeal lines, and lactate dialysates, would drastically reduce the cost of HD in low income countries

Table 1
 UREACREATININE
Instantaneous clearances (ml/min) 207-210 187-212
Reduction (%)71.2-73.269.6-71.8
Mass Conservation Index 0.94-1.050.92-1.02
   
Table 2  
   
UF Volume (ml) Deviation (%)Uncertainty (ml/h)
Prescribed Obtained   
2600-2760 2590-27300.4-1.2 2.5-7.5