Abstract: SA-PO426
Comparison of Mid and Conventional Dialysate Flow in Critically Ill Patients Undergoing Intermittent Dialysis
Session Information
- Hemodialysis and Frequent Dialysis: Clearance, Technology, Infection
November 05, 2022 | Location: Exhibit Hall, Orange County Convention Center‚ West Building
Abstract Time: 10:00 AM - 12:00 PM
Category: Dialysis
- 701 Dialysis: Hemodialysis and Frequent Dialysis
Authors
- Demirjian, Sevag, Cleveland Clinic, Cleveland, Ohio, United States
- Huml, Anne M., Cleveland Clinic, Cleveland, Ohio, United States
- George, Michael W., Cleveland Clinic, Cleveland, Ohio, United States
- Layne, Matthew, Cleveland Clinic, Cleveland, Ohio, United States
- Taliercio, Jonathan J., Cleveland Clinic, Cleveland, Ohio, United States
Background
Conventional dialysis is a water hungry medical procedure where potential savings in consumption and wastage are feasible without compromise in patient care. Kinetic modeling of urea has shown that dialysate flow rates (Qd) of 300 ml/min incur lower urea reduction ratio (URR) compared to conventional rates. We sought to compare urea clearance between mid and conventional flow rates, and the effect of filter size in real life clinical setting.
Methods
A retrospective observational study of critically ill patients requiring bedside intermittent dialysis. The study included dialysis treatments with prescribed and completed 4 hr treatments with achieved blood flow rate of 400 ml/min. ANOVA with p value of < .05 was used to compare URRs between 300 and 600 mL/min Qd and type of dialyzer use (Optiflux High Flux 160 vs 250).
Results
The three groups (Qd=300/F160, Qd=300/F250, and Qd=600/F160) were statistically different in post dialysis BUN, and URR achieved (Table). The mean URR was significantly different between Qd=300/F160 and Qd=600/F160 groups (.69 vs. .72, p=.03), but was similar between Qd=300/F250 and Qd=600/F160 (.71 vs. .72, p=.17).
Conclusion
Small solute clearance represented by URR delivered in critically ill patients was higher in dialysis treatments with Qd of 300 vs 600 mL/min. However, this difference was offset by the use of larger dialyzer. The current findings may have implications in hospital settings where water preservation is of priority.
| Qd=300/F160 (n=51) | Qd=300/F250 (n=102) | Qd=600/F160 (n=4019) | p value | |
| Age (yrs) | 60 (55, 72) | 57 (49, 69) | 61 (52, 69) | .06 |
| Weight (kg) | 83 (73, 92) | 84 (76, 111) | 86 (74, 106) | .28 |
| Dialysis duration (min) | 240 (235, 240) | 240 (235, 240) | 240 (235, 240) | .10 |
| BUN pre (mg/dL) | 57 (40, 74) | 50 (37, 70) | 51 (36, 71) | .29 |
| BUN post (mg/dL) | 16 (12, 24) | 13 (10, 19) | 14 (9, 20) | .03 |
| Urea reduction ratio | 0.69 (0.64, 0.73) | 0.71 (0.63, 0.77) | 0.72 (0.67, 0.78) | .01 |
*Blood flow rate = 400 ml/min