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Karin Moret, Diana C Grootendorst, Charles Beerenhout, Jeroen P Kooman
No abstract text is available yet for this article.
August 2009: NDT Plus
Jennifer Tan, Sumit Mohan, Leroy Herbert, Herman Anderson, Jen-Tse Cheng
Vascular catheter use for dialysis remains highly prevalent, however, it is frequently adversely affected by access recirculation (AR). We previously reported the utility of effective ionic dialysance (EID)/blood flow rate (Qb) ratio in identifying significant (>5%) AR in arteriovenous (AV) fistulas (Mohan et al ASAIO J 56:427-433, 2010). We present data from 58 patients, receiving hemodialysis via venous catheters (85% tunneled cuffed catheters) who underwent intermittent monitoring for AR with the saline dilution technique (Transonic HD02 monitor) and had EID and Qb measurements from Diascan biosensor in the Gambro Phoenix dialysis machine available...
September 2012: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
Joakim Cordtz, Jan Sternby
Hypotension during hemodialysis (HD) is a frequent and troublesome treatment complication. A decrease in the cardiac output (CO) due to an imbalance in the rates of fluid ultrafiltration vs. tissue reabsorption is a major cause of such episodes; thus, routine repeated measurements of CO during HD sessions could be of use in preventing its occurrence. We tested an experimental method (EXP) for measuring CO during HD using hardware already supplied with current Gambro dialysis machines. In 12 HD patients, CO was measured twice during dialysis by injecting a small (2 mL) bolus of highly concentrated saline into the patient's bloodstream and measuring the subsequent increase in dialysate conductivity using the Diascan technology...
March 2012: Artificial Organs
Francisco Maduell, Manel Vera, Marta Arias, Nuria Serra, Miguel Blasco, Eduardo Bergadá, Nestor Fontsere, Aleix Cases, Josep M Campistol
BACKGROUND: Ionic dialysance can provide accurate monitoring of dialysis dose during each hemodialysis session. Increasingly, hemodialysis machines incorporate devices that measure ionic dialysance, allowing the dialysis dose to be determined noninvasively in real time and in each session. Because Kt product was proposed as a measure of hemodialysis dose to avoid the reverse J-shaped curve between urea reduction ratio or Kt/V and mortality, we investigated whether ionic dialysance values and Kt measurements are affected by different ionic dialysance monitors (Diascan and online clearance monitoring [OCM]) and dialysis machines...
July 2008: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
Robert M Lindsay, Jan Sternby, Bo Olde, Roland Persson, Mary Ellen Thatcher, Kim Sargent
Measurement of blood flow rate (Qa) is used to monitor arteriovenous fistulas and grafts that are used for hemodialysis blood access. Most Qa measurements use indicator dilution techniques to measure the recirculation that is induced by the reversal of hemodialysis blood lines. R plus the dialysis circuit flow (Qb) allows the calculation of Qa. The principle of needle reversal also can be used with a dialysate urea monitor (e.g., DQM 200 [Gambro]) without injection of diluent; the effect of the reversal on urea concentration is observed...
September 2006: Clinical Journal of the American Society of Nephrology: CJASN
Karin Moret, Charles H Beerenhout, A Warmold L van den Wall Bake, Paul G Gerlag, Frank M van der Sande, Karel M Leunissen, Jeroen P Kooman
BACKGROUND: Ionic dialysance was recently introduced as a means to assess Kt/V (K(ID)t/V). With this method, urea distribution volume (V) has to be estimated. The primary aim of the present study was to assess the agreement between equilibrated Kt/V assessed by urea kinetic modelling (eKt/V) with K(ID)t/V taking into account different estimates of V, and to assess the monthly variation in V. Secondly, the mechanisms behind the intra-treatment changes in ionic dialysance and inter-treatment variability of K(ID)t/V were assessed...
August 2007: Nephrology, Dialysis, Transplantation
Pietro Pozzoni, Salvatore DI Filippo, Giuseppe Pontoriero, Francesco Locatelli
The attainment of a neutral sodium balance represents a major objective in hemodialysis patients. It requires that at the end of each dialysis session, total body water volume (V(f)) and total plasma water sodium concentration (Na(pwf)) are constant. Whereas to achieve a constant V(f) it is sufficient that ultrafiltration equals the interdialytic increase in body weight, it is impossible to predict the value of Na(pwf) and calculate the dialysate sodium concentration needed to obtain it without making use of kinetic mathematical models...
April 2007: Hemodialysis International
Lindsay J Chesterton, William S Priestman, Stewart H Lambie, Catherine A Fielding, Maarten W Taal, Richard J Fluck, Christopher W McIntyre
Considerable intrinsic intrapatient variability influences the actual delivery of Kt/V. The aim of this study is to examine the feasibility of using continuous online assessment of ionic dialysance measurements (Kt/V(ID)) to allow dialysis sessions to be altered on an individual basis. Ten well-established chronic hemodialysis (HD) patients without significant residual renal function were studied (mean age 65+/-4.3 [38-81] years, mean length of time on dialysis 66+/-18 [14-189] months). These patients had all been receiving thrice-weekly 4-hr dialysis using Integra dialysis monitors...
October 2006: Hemodialysis International
E Torregrosa, J Hernández-Jaras, H García-Pérez, R Pons-Prades, C Calvo-Gordo, A Ríus-Peris, J J Sánchez-Canel, M Pin-Godos
The "gold standard" method to measure the mass balance achieved during dialysis for a given solute is based on the total dialysate collection. This procedure is unfeasible and too cumbersome. For this reason, alternative methods have been proposed including the urea kinetic modelling (Kt/V), the measurement of effective ionic dialysance (Diascan), and the continuous spent sampling of dialysate (Quantiscan). The aim of this study was to compare the reliability and agreement of these two methods with the formulas proposed by the urea kinetic modelling for measuring the dialysis dose and others haemodialysis parameters...
2006: Nefrología: Publicación Oficial de la Sociedad Española Nefrologia
Salvatore Di Filippo, Pietro Pozzoni, Celestina Manzoni, Simeone Andrulli, Giuseppe Pontoriero, Francesco Locatelli
BACKGROUND: On-line determination of ionic dialysance (ID) has been used to measure the clearance of small solutes like urea. However, attempts to determine the in vivo relationship between ID and urea clearance have led to discordant findings. The aim of this study was to determine the relationship between the mean values of repeated instantaneous determinations of ID throughout a dialysis session ((m)ID), obtained using a single-step inlet dialysate conductivity profile, and the mean values of urea clearance corrected for access recirculation (K(eu1)), total recirculation (access plus cardiopulmonary recirculation, K(eu2)), and the entire postdialysis urea rebound (K(wb))...
November 2005: Kidney International
P Pozzoni, M Pozzi, S Di Filippo
PURPOSE: It has been suggested that ionic dialysance (ID) can adequately estimate the "effective" urea clearance (eK), i.e. urea clearance corrected for total (access and cardiopulmonary) recirculation. Unfortunately, the results obtained by different authors in determining the relationship existing in vivo between ID and eK do not always agree. Furthermore, it has been recently evidenced that ID values could be different, according to the different methods used to modify the inlet dialysate conductivity during ID measurement...
November 2004: Giornale Italiano di Nefrologia: Organo Ufficiale Della Società Italiana di Nefrologia
J L Teruel, M Fernández Lucas, M Arambarri, J L Merino, R Echarri, C Alarcón, R Marcén, M Rivera, J Ortuño
The Diascan equipment (Hospal) measures ionic dialysane which it derives the K and the Kt. If we divide the Kt obtained with Diascan between the Kt/V obtained by a simplified formula, it result a value of V for every patient. Entering this V in the Diascan software we can obtain a Kt/V (Diascan Kt/V), similar in theory to the simplified Kt/V. In the year 2002 we have controlled the delivered dialysis in our unit with the Diascan Kt/V. The aim of the present study was to study the agreement between de Diascan Kt/V and the Lowrie Kt/V...
September 2003: Nefrología: Publicación Oficial de la Sociedad Española Nefrologia
Christopher W McIntyre, Stewart H Lambie, Maarten W Taal, Richard J Fluck
INTRODUCTION: Adequate delivered dose of solute removal (as assessed by urea reduction and calculation of Kt/V) is an important determinant of clinical outcome in chronic haemodialysis (HD) patients. The requirement for multiple blood sampling and efforts taken to minimize the effects of rebound on post-treatment samples ensure Kt/V is measured only intermittently. On-line conductivity monitoring (using sodium flux as a surrogate for urea) allows the repeated non-invasive measurement of Kt/V on each HD treatment...
March 2003: Nephrology, Dialysis, Transplantation
Karin Moret, Daxenos Hassell, Jeroen P Kooman, Frank van der Sande, Paul G G Gerlag, A Warmold L van den Wall Bake, Jarno van de Bogaart, Karel M L Leunissen
BACKGROUND: Although a higher dialysate sodium concentration (DNa) is frequently used to improve haemodynamic stability during haemodialysis, few studies have compared ionic mass balance (IMB) during different DNa. Moreover, DNa is usually a standard prescription, whereas inter-individual pre-dialytic serum sodium levels may differ widely. The aims of the study were to assess IMB and the decline in blood volume (DeltaBV) during isovolaemic HD as well as during HD combined with ultrafiltration (UF) during DNa [140], DNa [144], and an individualized DNa [ind], in which DNa is equal to pre-HD plasma conductivity x 10...
August 2002: Nephrology, Dialysis, Transplantation
Lucile Mercadal, Emmanuel Challier, Philippe Cluzel, Abdelaziz Hamani, Hacène Boulechfar, Zhora Boukhalfa, Hassane Izzedine, Nader Bassilios, Benoît Barrou, Gilbert Deray, Thierry Petitclerc
BACKGROUND/AIM: The measurement of the vascular access blood flow rate (Q(a)) in chronic hemodialyzed patients was proposed to predict access thrombosis. We have recently presented a new method based on the measurements of ionic dialysance at normal and reversed positions of the blood lines. We evaluate the reliability of the measurement of Q(a) by this method in detecting significant access stenoses. METHODS: Twenty-five patients on chronic hemodialysis and having a vascular access cannulated with two needles were studied...
2002: Blood Purification
R M Lindsay, B Bene, N Goux, A P Heidenheim, C Landgren, J Sternby
Effective ionic dialysance (EID) can be measured from dialyzer inlet and outlet conductivity changes following two steps of dialysate conductivity. Relationships between EID and in vivo urea clearances were studied four times per hemodialysis treatment in eight patients, each undergoing six hemodialysis treatments (192 data sets). Dialyzer blood flow was varied from 190 to 500 mL/min. Dialysate flow was constant (751 to 771 mL/min), and a standard dialyzer (700 HG; Cobe, Lakewood, CO) was used. Double samples were drawn for arterial, venous, and dialysate urea measurements...
September 2001: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
L A Leiter, A Barr, A Bélanger, S Lubin, S A Ross, H D Tildesley, N Fontaine et al.
OBJECTIVE: To assess the prevalence of undiagnosed diabetes and glucose intolerance in individuals > or =40 years of age who contacted their family physician for routine care. RESEARCH DESIGN AND METHODS: The study used a stratified randomized selection of family physicians across Canada that was proportional to provincial and urban/rural populations based on Statistics Canada Census data (1996). Consecutive patients > or =40 years of age were screened for diabetes...
June 2001: Diabetes Care
J L Teruel, M Fernández Lucas, R Marcén, J R Rodríguez, M Rivera, F Liaño, J Ortuño
UNLABELLED: The Diascan equipment (Hospal) measures ionic dialysance from which it derives the Kt/V. It is automatic, does not need blood samples and displays the results in real time. The aim of the present study was to compare the Diascan Kt/V with the Kt/V obtained with four simple formulas: two based on a single pool model of urea kinetics (Lowrie 1983 and Daugirdas 1993) and the other based on the two pool model (Maduell formulation applied to Lowrie Kt/V and that proposed by Daugirdas 1995)...
January 2001: Nefrología: Publicación Oficial de la Sociedad Española Nefrologia
F Maduell, V Navarro
One of the main goals of dialysis is to reach a correct sodium balance. Dietary sodium restriction facilitates control of thirst, water overload, hypertension and cardiac failure. Nowadays, it is possible to estimate sodium mass transfer and known interdialytic salt intake, by means of non-invasive methods. The use of dialysate sodium profiles improves dialysis tolerance but it has been reported that interdialytic thirst may increase because of an inappropriate sodium balance. The aim of this study was to evaluate the usual salt intake in hemodialysis patients, the effects on interdialytic gain weight, arterial pressure, blood volume preservation and dialysis tolerance of two different profiles of dialysate sodium and an additional session with salt restriction...
January 2001: Nefrología: Publicación Oficial de la Sociedad Española Nefrologia
T Petitclerc
On-line monitoring of dialysate conductivity is now a standard equipment (called 'Diascan') of the dialysis monitor Integra (Hospal, Italy). From the record of the dialysate conductivity at the dialyser inlet and outlet, the Diascan calculates the values of patient's plasma conductivity and of ionic dialysance which is a weighed average of the dialysances of all ions of quantitative importance in plasma and dialysate. Because there is an equivalence between the transfer characteristics of urea and electrolytes, the ionic dialysance reflects the urea clearance corrected for recirculation...
November 1999: Nephrology, Dialysis, Transplantation
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