scholarly journals Effect Of Surface Area Of Dialyzer Membrane On The Adequacy Of Haemodialysis

2012 ◽  
Vol 7 (2) ◽  
pp. 9-11 ◽  
Author(s):  
NS Chowdhury ◽  
FMM Islam ◽  
F Zafreen ◽  
BA Begum ◽  
N Sultana ◽  
...  
Keyword(s):  
Renal Disease ◽  
Surface Area ◽  
End Stage Renal Disease ◽  
Membrane Surface ◽  
Reduction Ratio ◽  
Urea Clearance ◽  
Membrane Surface Area ◽  
Stage Renal Disease ◽  
End Stage ◽  
Urea Reduction Ratio

Introduction: Patients with end stage renal disease require 12 hours of haemodialysis per week in three equal sessions (4 hours/day for 3 days/week). But the duration and frequency of treatment can be reduced by increasing the surface area of the dialyzer membrane. Methods: In this prospective study 40 patients of end stage renal disease receiving haemodialysis for more than six months were included to observe the effects of increment in the surface area of the dialyzer membrane on the adequacy of haemodialysis. Result: It was observed that 20 patients receiving haemodialysis on a dialyzer with membrane surface area of 1.2 m² did not have satisfactory solute clearance index. Urea reduction ratio was 45.9 ± 3.03 and fractional urea clearance (Kt/V) was 0.76 ± 0.09. On the other hand patients (20 cases) receiving haemodialysis on a dialyzer with membrane surface area of 1.3 m² had a urea reduction ratio 50.76± 5.16 and fractional urea clearance (Kt/V) 0.91 ± 0.16. All the patients of both groups received dialysis for 8 hours/week in two equal sessions (4 hours/day for 2 days/week). Statistically the increment was significant (p<0.001). Conclusion: This study reveals, adequacy of dialysis can be increased by increasing the surface area of the dialyzer membrane. So, considering the poor socioeconomic condition of Bangladesh and patients' convenience, a short duration, low cost dialysis regime can be tried by increasing the surface area of dialyzer membrane. DOI: http://dx.doi.org/10.3329/jafmc.v7i2.10387 JAFMC 2011; 7(2): 9-11

C‐reactive protein levels are associated with periodontitis and periodontal inflamed surface area in adults with end‐stage renal disease

2020 ◽  
Author(s):  
Caroline Schöffer ◽  
Leandro Machado Oliveira ◽  
Samantha Simoni Santi ◽  
Raquel Pippi Antoniazzi ◽  
Fabricio Batistin Zanatta
Keyword(s):  
Renal Disease ◽  
Surface Area ◽  
End Stage Renal Disease ◽  
C Reactive Protein ◽  
Protein Levels ◽  
Reactive Protein ◽  
Stage Renal Disease ◽  
End Stage

scholarly journals The Effect of Increasing Surface Area of Dialyzer Membrane on Adequacy of Hemodialysis

2021 ◽  
Vol 2 (6) ◽  
pp. 19-23
Author(s):  
Faiza Saeed ◽  
Ashar Alam ◽  
Shoukat Memon ◽  
Salman Imtiaz
Keyword(s):  
Renal Disease ◽  
Surface Area ◽  
End Stage Renal Disease ◽  
Low Cost ◽  
Randomized Control ◽  
Stage Renal Disease ◽  
End Stage ◽  
Hemodialysis Prescription ◽  
Esrd Patients ◽  
Control Study

Introduction: The patients with end stage renal disease requires 12 hours of hemodialysis per week divided in three equal sessions (4 hours/day for 3 days/week). Some studies show that adequacy of hemodialysis can be maintained by increasing the surface area of the dialyzer membrane and decreasing the frequency of treatment which can help the poor socioeconomic status patients in getting effective hemodialysis at a low cost. Objectives: To observe whether by increasing the surface area of dialyzer the dose of dialysis can be reduced against the standard hemodialysis prescription. Study design: Randomized Control Trial. Study Duration: Six months from March 2017 to August 2017. Settings: Department of Nephrology, The Indus Hospital Karachi. Subjects: ESRD patients undergoing Hemodialysis for at least 6 months at The Indus Hospital Karachi. Methods: In this prospective randomized control study, a total of 60 patients of end stage renal disease receiving hemodialysis for more than six months were included and divided into 2 groups randomly (Arm-A: twice weekly dialysis using a larger surface area dialyzer and Arm-:B thrice weekly dialysis using regular surface area dialyzer). Results: A total of 59 (30 in Arm A and 29 in Arm B) patients were enrolled in the study out of which majority of the patients were male (59.3%). On average significantly higher URR and eKt/V were reported in Arm A whereas, higher mean standard (weekly) stdKt/V was reported in Arm-B. Conclusion: Standard protocols should be followed to maintain the adequacy of Hemodialysis.

Differences between KT/V Measured during Dialysis and KT/V Predicted from Manufacturer Clearance Data

1992 ◽  
Vol 15 (8) ◽  
pp. 465-469 ◽  
Author(s):  
L.K. Saha ◽  
J.C. Van Stone
Keyword(s):  
Renal Disease ◽  
End Stage Renal Disease ◽  
Urea Clearance ◽  
Blood Flows ◽  
The Mean ◽  
Stage Renal Disease ◽  
End Stage

We retrospectively analyzed data from 3,863 dialysis treatments in 329 end-stage renal disease patients over a period of 33 months to evaluate the accuracy of in vitro KT/V estimated by manufacturer's urea clearance data in relation to in vivo measured KT/V. In 1,087 urea clearances measured, mean actual clearance was 87% of predicted. At all blood flows, actual clearances were significantly lower than predicted (8-16% lower than predicted). In 2,807 KT/V measurements, predicted KT/V was 1.238 ± 0.005 whereas the mean of actual measured KT/V was 16% lower or 1.024 ± 0.005 (P < 0.0001). At different blood flows and with different dialyzers, predicted KT/V overestimated actual values. With increasing numbers of reuse, actual/predicted clearance ratios and actual/predicted KT/V ratios progressively dropped. Prescribing dialysis treatments using manufacturer's in vitro generated clearance data can lead to marked underdialysis of patients.

scholarly journals Low dialysate [K+] decreases efficiency of hemodialysis and increases urea rebound.

1998 ◽  
Vol 9 (11) ◽  
pp. 2124-2128 ◽  
Author(s):  
G M Dolson ◽  
H J Adrogué
Keyword(s):  
Skeletal Muscle ◽  
Blood Flow ◽  
End Stage Renal Disease ◽  
Blood Perfusion ◽  
Tissue Perfusion ◽  
Reduction Ratio ◽  
Urea Kinetics ◽  
Stage Renal Disease ◽  
End Stage ◽  
Urea Reduction Ratio

In a previous study, it was reported that hemodialysis with dialysate [K+] (KD) of 1.0 or 2.0 mmol/L caused an increase in BP shortly after completion of treatment due to arteriolar constriction. With this background, it was hypothesized that a low KD might decrease dialysis efficiency by a similar mechanism. To evaluate this hypothesis, paired observations of two consecutive 3-h treatments, with KD of 1.0 or 3.0 mmol/L, were performed in 14 stable end-stage renal disease patients. A KD of 1.0 mmol/L resulted in lower values for both urea reduction ratio and Kt/V evaluated at completion of dialysis and 1 h thereafter. Values at equilibrium were urea reduction ratio 42+/-1% versus 47+/-2% (P < 0.02), Kt/V 0.65+/-0.03 versus 0.73+/-0.03 (P < 0.02) for KD 1.0 or 3.0 mmol/L, respectively. The mechanisms responsible for the observed differences in dialysis efficiency were examined using a urea kinetics model that predicts urea sequestration caused by impaired blood flow to urea-rich tissues. For this purpose, urea rebound and its effect on Kt/V (by means of deltaKt/V, calculated as equilibrated minus single pool value) with KD 1.0 and 3.0 mmol/L were assessed. Greater urea rebound, 12.8+/-1.6% versus 8.6+/-1.4% (P < 0.001), and larger deltaKt/V, 0.12+/-0.01 versus 0.10+/-0.02 (P < 0.02), were observed with KD 1.0 mmol/L compared with 3.0 mmol/L. The theoretical model accurately predicted the deltaKt/V observed with KD 1.0 mmol/L. It is concluded that a low KD decreases dialysis efficiency. This effect is likely caused by reduced blood perfusion to nonvisceral organs, largely skeletal muscle. Conversely, hemodialysis with KD 3.0 mmol/L facilitates tissue perfusion, minimizes urea trapping in poorly perfused areas, and improves the efficiency of this treatment modality.

Parathyroid Dysfunction in End Stage Renal Disease

1980 ◽  
Vol 13 (1) ◽  
pp. 193-201
Author(s):  
Philip J. DìTella ◽  
Gordon R. Lang
Keyword(s):  
Renal Disease ◽  
End Stage Renal Disease ◽  
Parathyroid Dysfunction ◽  
Stage Renal Disease ◽  
End Stage
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