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Kidney Week

Abstract: PO1205

Ultrafiltration Accuracy of the Tablo® Hemodialysis System During 24-Hour Therapy

Session Information

Category: Dialysis

  • 701 Dialysis: Hemodialysis and Frequent Dialysis

Authors

  • Aragon, Michael A., Outset Medical, Inc., San Jose, California, United States
  • Kerdok, Amy, Outset Medical, Inc., San Jose, California, United States
  • Schumacher, Josh, Outset Medical, Inc., San Jose, California, United States
Background

Ultrafiltration (UF) accuracy is vital to ICU management of patients with kidney failure. Renal replacement options include intermittent hemodialysis, continuous renal replacement therapy and slow low efficiency dialysis. Regardless of therapy, clinicians need confidence that the dialysis device chosen will accurately remove volume to achieve the prescribed goal.

The Tablo Hemodialysis System is an all-in-one system with on demand water purification and dialysate production indicated for use in clinic, hospital, and home settings. Prior reports have demonstrated UF accuracy over a wide range of conditions up to 12 hours.

The objective was to report on the accuracy of Tablo’s unique flow balancing technology over 24 hours of continuous therapy utilizing HD, isolated ultrafiltration, or a sequential therapy modes.

Methods

Bench testing was conducted to evaluate UF accuracy across clinically relevant parameters during a simulated 24-hour treatment with a single cartridge. Ten distinct treatment conditions were created. Effluent was weighed and compared to the prescribed goal at treatment completion. Treatment conditions included: mode (HD, UF-Only, and Sequential therapy (HD→UF only, UF only→HD), blood flow rates (Qb) from 150-400 ml/min, dialysate flow rates (Qd) from 50-300 ml/min, UF goals from 0 to 1.9 L/hr, and low to high venous and arterial pressure.

Results

Thirty simulated treatments were performed. Twenty-four treatments were performed with Qb from 150-250ml/min and 6 were performed with Qb 300 or greater. Twenty-seven treatments had fluid removal goals between 250ml/hr to 2000ml/hr and 3 treatments were performed with a UF goal of 0ml/hr.

Ninety-three percent of treatments were within 20ml/hr of accuracy (< 480ml of total error). Sixty-seven percent of treatments were within 10ml/hr of the prescribed UF goal (< 240ml of total error). Blood flow and UF rate showed correlation to UF accuracy with minimum error between Qb 200-300ml/min and UF rate between 0-1000ml/hr. There was no impact to UF accuracy from treatment mode or dialysate flow rate.

Conclusion

Tablo’s proprietary flow balancing technology maintains a high level of UF accuracy across a wide range of 24-hour treatment prescriptions. Optimal accuracy was noted at parameters typically prescribed in continuous renal replacement therapy.

Funding

  • Commercial Support