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Influencia en la dosis de diálisis de diferentes flujos de líquido dializante en el paciente tratado con hemodiafiltración on-line o hemodiálisis convencional

DOI: 10.4321/S1139-13752011000100006

Keywords: dialysis dose, dialysis fluid flow rate, online haemodiafiltration, individualization of treatment.

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Abstract:

the dialysis dose affects survival of patients undergoing dialysis, as well as affecting the correction of anaemia, the nutritional state and the control of blood pressure, among others. some authors have indicated the dialysis fluid flow rate as a determining factor in the dialysis dose for patients undergoing high-flow haemodialysis and haemodiafiltration. the aim of this study is to evaluate the impact on the dialysis efficacy of different flow rates of dialysis fluid in patients treated with on-line post-dilution haemodiafiltration and conventional haemodialysis, by measuring the final convective volume and rinse solution volume of small molecules using kt. in all patients, 9 consecutive dialysis sessions were carried out varying the qd: 3 sessions with qd 500 ml/min, 3 sessions with qd 800 ml/min and 2 sessions with autoflow. from the results obtained, kt is shown to be significantly higher with qd 800 ml/min (59.69 ± 6.07 litres) compared to qd 500 ml/min (56.51 ± 6.33 litres, p<0.001) and autoflow (58.02 ± 4.89 litres); and kt in autoflow was found to be higher (p<0.001) than qd 500 ml/min. the increase in flow rate of dialysis fluid means an increase in the dialysis dose in patients treated with online haemodiafiltration. the autoflow achieves an appreciable increase in dose compared to qd of 500 ml/min with a minimum additional cost, and should therefore be considered as a measure in an overall treatment framework, permitting individualization of treatment for each patient.

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