Smart, Individualized Green Hemodiafiltration ‐ Effects of Individualized Dialysate Flow Through AutoFlow on Dialysate Consumption and Parameters of Dialysis Adequacy in the Setting of Online Hemodiafiltration

Authors:
Publisher website
Google Scholar
Abstract
Introduction: High‐dose online HDF compared with hemodialysis reduces all‐cause mortality, but increases water consumption. We postulate that the conundrum could be solved by individualizing dialysate flow. Methods: Thirty CKD5D patients undergoing online HDF post‐dilution were changed from fixed dialysate flow (500 mL/min) to individualized dialysate flow, resulting in a dialysate flow that was always 20% higher than the blood flow. Kt / V urea , K + , Phos, and pill burden in one quater pre as well as four quarters after the change were evaluated. Results: The practice change resulted in a reduction of the fixed dialysate flow from 500 to 360 (240–383) mL/min. Parameters of dialysis adequacy did not change; neither did the medication. Conclusion: An individualization of the dialysate flow saved about 36 L dialysate per session; hence, even in light of 23 L used for online HDF, the net burden on the environment could be reduced. Neither dialysis adequacy nor pill burden was negatively affected.

This publication has 12 references indexed in Scilit: