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Measuring intradialyser transmembrane and hydrostatic pressures: pitfalls and relevance in haemodialysis and haemodiafiltration
- Source :
- Clinical Kidney Journal, Clinical Kidney Journal, 2020, 13 (4), pp.580-586. ⟨10.1093/ckj/sfz033⟩, Clinical Kidney Journal, Oxford University Press, 2020, 13 (4), pp.580-586. ⟨10.1093/ckj/sfz033⟩
- Publication Year :
- 2020
- Publisher :
- HAL CCSD, 2020.
-
Abstract
- Background Post-dilutional haemodiafiltration (HDF) with high convection volumes (HCVs) could improve survival. HCV-HDF requires a significant pressure to be applied to the dialyser membrane. The aim of this study was to assess the pressure applied to the dialysers in HCV-HDF, evaluate the influence of transmembrane pressure (TMP) calculation methods on TMP values and check how they relate to the safety limits proposed by guidelines. Methods Nine stable dialysis patients were treated with post-dilutional HCV-HDF with three different convection volumes [including haemodialysis (HD)]. The pressures at blood inlet (Bi), blood outlet (Bo) and dialysate outlet (Do) were continuously recorded. TMP was calculated using two pressures (TMP2: Bo, Do) or three pressures (TMP3: Bo, Do, Bi). Dialysis parameters were analysed at the start of the session and at the end of treatment or at the first occurrence of a manual intervention to decrease convection due to TMP alarms. Results During HD sessions, TMP2 and TMP3 remained stable. During HCV-HDF, TMP2 remained stable while TMP3 clearly increased. For the same condition, TMP3 could be 3-fold greater than TMP2. This shows that the TMP limit of 300 mmHg as recommended by guidelines could have different effects according to the TMP calculation method. In HCV-HDF, the pressure at the Bi increased over time and exceeded the safety limits of 600 mmHg provided by the manufacturer, even when respecting TMP safety limits. Conclusions This study draws our attention to the dangers of using a two-pressure points TMP calculation, particularly when performing HCV-HDF.
- Subjects :
- medicine.medical_specialty
medicine.medical_treatment
[SDV]Life Sciences [q-bio]
Hydrostatic pressure
ULTRAFILTRATION COEFFICIENT
030232 urology & nephrology
030204 cardiovascular system & hematology
haemodiafiltration
Dialysis patients
convection volume
[SDV.MHEP.UN]Life Sciences [q-bio]/Human health and pathology/Urology and Nephrology
Transmembrane pressure
03 medical and health sciences
Dialysis solutions
0302 clinical medicine
Internal medicine
medicine
AcademicSubjects/MED00340
ALL-CAUSE MORTALITY
Transplantation
transmembrane pressure
[SDV.MHEP] Life Sciences [q-bio]/Human health and pathology
integumentary system
business.industry
Original Articles
[SDV.MHEP.UN] Life Sciences [q-bio]/Human health and pathology/Urology and Nephrology
Calculation methods
haemodialysis
[SDV] Life Sciences [q-bio]
Nephrology
ultrafiltration
Cardiology
Hemodialysis
Dialysis (biochemistry)
business
ONLINE HEMODIAFILTRATION
All cause mortality
[SDV.MHEP]Life Sciences [q-bio]/Human health and pathology
Subjects
Details
- Language :
- English
- ISSN :
- 20488505 and 20488513
- Database :
- OpenAIRE
- Journal :
- Clinical Kidney Journal, Clinical Kidney Journal, 2020, 13 (4), pp.580-586. ⟨10.1093/ckj/sfz033⟩, Clinical Kidney Journal, Oxford University Press, 2020, 13 (4), pp.580-586. ⟨10.1093/ckj/sfz033⟩
- Accession number :
- edsair.doi.dedup.....709eb56776f0b6fe10e20ea5b701b6af