A Model to Predict Optimal Dialysate Flow

Diffusive clearance depends on blood (Qb) and dialysate flow (Qd) rates and the overall mass transfer area coefficient (KoA) of the dialyzer. In this article we describe a model to predict an appropriated AutoFlow (AF) factor (AF factor = Ratio Qd/Qb), that is able to provide adequate Kt/V for hemod...

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Bibliographic Details
Published in:Therapeutic apheresis and dialysis 2012-04, Vol.16 (2), p.152-158
Main Authors: Alayoud, Ahmed, Benyahia, Mohammed, Montassir, Dina, Hamzi, Amine, Zajjari, Yassir, Bahadi, Abdelali, El Kabbaj, Driss, Maoujoud, Omar, Aatif, Taoufik, Hassani, Kawtar, Oualim, Zouhir
Format: Article
Language:English
Subjects:
Adult
Aged
AutoFlow factor
Blood Flow Velocity
Clearance
Cross-Over Studies
Dialysate economy
Dialysate flow
Dialysis Solutions - administration & dosage
Dialysis Solutions - pharmacokinetics
Female
Humans
Kidney Failure, Chronic - physiopathology
Kidney Failure, Chronic - therapy
Male
Michaels equation
Middle Aged
Models, Theoretical
Prospective Studies
Renal Dialysis - methods
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Summary:Diffusive clearance depends on blood (Qb) and dialysate flow (Qd) rates and the overall mass transfer area coefficient (KoA) of the dialyzer. In this article we describe a model to predict an appropriated AutoFlow (AF) factor (AF factor = Ratio Qd/Qb), that is able to provide adequate Kt/V for hemodialysis patients (HDP), while consuming lower amounts of dialysate, water and energy during the treatment. We studied in vivo the effects of three various Qd on the delivered dose of dialysis in 33 stable HDP. Hemodialysis was performed at Qd of 700 mL/mn, 500 mL/mn, and with AF, whereas specific dialysis prescriptions (treatment time, blood flow rate [Qb], and type and size of dialyzer) were kept constant. The results showed that increasing the dialysate flow rate more than the model of AF predicted had a small effect on the delivered dose of dialysis. The Kt/V (mean ± SD) was 1.52 ± 0.16 at Qd 700, 1.50 ± 0.16 at Qd 500, and 1.49 ± 0.15 with AF. The use of the AF function leads to a significant saving of dialysate fluid. The model predicts the appropriate AF factor that automatically adjusts the dialysate flow rate according to the effective blood flow rate of the patient to achieve an appreciable increase in dialysis dose at the lowest additional cost.
ISSN:1744-9979
1744-9987
DOI:10.1111/j.1744-9987.2011.01040.x