dialysis. extracorporeal dialysis: techniques and adequacy

Nephrology Dialysis Transplantation 30 (Supplement 3): iii229–iii256, 2015 doi:10.1093/ndt/gfv179.23

DIALYSIS. EXTRACORPOREAL DIALYSIS: TECHNIQUES AND ADEQUACY FP494

ACHIEVABILITY OF RECOMMENDED CONVECTION VOLUMES IN HEMODIAFILTRATION ON-LINE (HDF-OL)

Anastasia Sabodash1,2, Gennady Zemchenkov2, Natalya Kazantseva2, Oksana Makarova2, Alexander Zemchenkov1, Yan Proletov3 and Karina Salikhova2 1 First St.Petersburg State Medical University named by I.P.Pavlov, Nephrology and Dialysis Chair, St.-Petersburg, Russian Federation, 2BBraun Avitum Russland Clinics, Dialysis Units, St.-Petersburg, Russian Federation, 3BBraun Avitum Russland Clinics, Dialysis units, St.-Petersburg, Russian Federation Introduction and Aims: In order to evaluate the achievability of the recommended convection volume (CVol) (EUDIAL: 24 liter per HDF session) by every stable patient all suitable patients from single dialysis center were included in the study. Methods: Out of 112 stable patients 44 were excluded from study (19 - refused, 3 had Hb level > 14 g/dl without EPO, 7 had low access blood flow, 2 complained on poor tolerance of HDF, 12 - participate in other studies, 1 with Fabri disease received predilution HDF-OL 4 times a week). The mean age of 78 patients was 54±13 y; duration of RRT was 66±65 mo; at baseline 54 patients received hemodialysis (HD) and 13 patients - HDF-OL in postdilution mode with mean CVol 21.1±1.6 liters on DIALOG+ machines with high-flux dialyzers and hemofilters Xevonta18⋯23 and Diacap20⋯23. The duration of sessions was 259±18 min and did not change during study. 16 patients had severe vascular diseases (stroke in anamnesis - 9, MI or severe CHF - 7). Results: The results of the attempts to reach CVol no less than 24 l in 3 sequential

sessions are shown in table. Extracorporeal blood flow rate at baseline differ in patients who achieved (“achiever”) and did not achieve (“non-achiever”) target CVol: 353±21 v. 339±19 ml/min, р=0.035; three patients who did not achieve target CVol at first session became “achiever” after increase of blood flow by 30-50 ml/min; in group of “non-achievers” at start the blood flow rate increased significantly: 358±20 v. 339±19 ( p