학술논문
Practical implementation and clinical benefits of the new automated dialysate sodium control biosensor.
Document Type
Academic Journal
Author
Maduell F; Department of Nephrology, Hospital Clínic Barcelona, Barcelona, Spain.; Broseta JJ; Department of Nephrology, Hospital Clínic Barcelona, Barcelona, Spain.; Rodríguez-Espinosa D; Department of Nephrology, Hospital Clínic Barcelona, Barcelona, Spain.; Casals J; Department of Nephrology, Hospital Clínic Barcelona, Barcelona, Spain.; Escudero V; Department of Nephrology, Hospital Clínic Barcelona, Barcelona, Spain.; Gomez M; Department of Nephrology, Hospital Clínic Barcelona, Barcelona, Spain.; Rodas LM; Department of Nephrology, Hospital Clínic Barcelona, Barcelona, Spain.; Arias-Guillén M; Department of Nephrology, Hospital Clínic Barcelona, Barcelona, Spain.; Vera M; Department of Nephrology, Hospital Clínic Barcelona, Barcelona, Spain.; Fontseré N; Department of Nephrology, Hospital Clínic Barcelona, Barcelona, Spain.
Source
Publisher: Oxford University Press Country of Publication: England NLM ID: 101579321 Publication Model: eCollection Cited Medium: Print ISSN: 2048-8505 (Print) Linking ISSN: 20488505 NLM ISO Abbreviation: Clin Kidney J Subsets: PubMed not MEDLINE
Subject
Language
English
ISSN
2048-8505
Abstract
Background: A key feature of dialysis treatment is the prescription of dialysate sodium (Na). This study aimed to describe the practical implementation of a new automated dialysate Na control biosensor and to assess its tolerance and the beneficial clinical effects of isonatraemic dialysis.
Methods: A prospective study was carried out in 86 patients who, along with their usual parameters, received the following five consecutive phases of treatment for 3 weeks each: phase 0: baseline 5008 machine; phases 1 and 2: 6008 machine without activation of the Na control biosensor and the same fixed individualized Na dialysate prescription or adjusted to obtain similar conductivity to phase 0; phases 3 and 4: activated Na control to isonatraemic dialysis (Na dialysate margins 135-141 or 134-142 mmol/L).
Results: When the Na control was activated, the few episodes of cramps or hypotension disappeared when the lower dialysate Na margin was increased by 1 or 2 mmol/L. The activated Na control module showed significant differences compared with baseline and the non-activated Na module in final serum Na values, diffusive Na balance, and changes in pre- to postdialysis plasma Na values. The mean predialysis systolic blood pressure value was significantly lower in phase 4 than in phase 1. There were no significant differences in total Na balance in the four 6008 phases evaluated.
Conclusions: The implementation of the automated dialysate Na control module is a useful new tool, which reduced the diffusive load of Na with good tolerance. The module had the advantages of reducing thirst, interdialytic weight gain and intradialytic plasma Na changes.
Competing Interests: The authors declare no financial support for the project. F.M. has received consultancy fees and lecture fees from Baxter, Fresenius Medical Care, Medtronic, Nipro, Toray and Vifor. The other authors declare no conflicts of interest.
(© The Author(s) 2023. Published by Oxford University Press on behalf of the ERA.)
Methods: A prospective study was carried out in 86 patients who, along with their usual parameters, received the following five consecutive phases of treatment for 3 weeks each: phase 0: baseline 5008 machine; phases 1 and 2: 6008 machine without activation of the Na control biosensor and the same fixed individualized Na dialysate prescription or adjusted to obtain similar conductivity to phase 0; phases 3 and 4: activated Na control to isonatraemic dialysis (Na dialysate margins 135-141 or 134-142 mmol/L).
Results: When the Na control was activated, the few episodes of cramps or hypotension disappeared when the lower dialysate Na margin was increased by 1 or 2 mmol/L. The activated Na control module showed significant differences compared with baseline and the non-activated Na module in final serum Na values, diffusive Na balance, and changes in pre- to postdialysis plasma Na values. The mean predialysis systolic blood pressure value was significantly lower in phase 4 than in phase 1. There were no significant differences in total Na balance in the four 6008 phases evaluated.
Conclusions: The implementation of the automated dialysate Na control module is a useful new tool, which reduced the diffusive load of Na with good tolerance. The module had the advantages of reducing thirst, interdialytic weight gain and intradialytic plasma Na changes.
Competing Interests: The authors declare no financial support for the project. F.M. has received consultancy fees and lecture fees from Baxter, Fresenius Medical Care, Medtronic, Nipro, Toray and Vifor. The other authors declare no conflicts of interest.
(© The Author(s) 2023. Published by Oxford University Press on behalf of the ERA.)