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Titolo Modifiable factors associated with achievement of high-volume post-dilution hemodiafiltration: results from an international study
Autore Daniele Marcelli1,2, Pascal Kopperschmidt3, Inga Bayh1, Tomas Jirka4, Jose I. Merello5, Pedro Ponce6, Erzebeth Ladanyi7, Attilio Di Benedetto8, Reina Dovc-Dimec9, Jaroslav Rosenberger10, Stefano Stuard1, Caecilia Scholz1, Aileen Grassmann1, Bernard Canaud1 - 1 Fresenius Medical Care, Bad Homburg – Germany - 2 Danube University, Krems – Austria - 3 Fresenius Medical Care, Schweinfurt – Germany - 4 NephroCare Czech Republic, Prague - Czech Republic - 5 NephroCare Spain, Madrid – Spain - 6 NephroCare Portugal, Lisbon – Portugal - 7 NephroCare Hungary, Miskolc – Hungary - 8 NephroCare Italy, Naples – Italy - 9 NephroCare Slovenia, Ljubljana – Slovenia - 10 NephroCare Slovak Republic, Piestany - Slovak Republic
Referenza Int J Artif Organs 2015 DOI: 10.5301/ijao.5000414
Contenuto

Background: The aim was to investigate factors associated with the successful achievement of ≥21 l/session of substitution fluid volume in patients on post-dilution hemodiafiltration.

Methods: 3315 patients treated in 6 European countries with the Fresenius 5008 CorDiax machine including the AutoSub Plus feature were considered. Variables that showed a relationship with convection volume were entered in a multivariable logistic regression model.

Results: Mean blood flow was 379 ± 68 ml/min. Median substitution volume was 24.7 L (IQR 22.0-27.4 L). Mean filtration fraction was 28.3 ± 4.1%. 81.5% of sessions qualified as high-volume HDF (substitution volumes ≥21 L).

Higher age, dialyzer surface area, blood flow and treatment time were positively associated with the achievement of ≥21 L substitution volume; higher body mass index, male gender, higher hematocrit, graft or catheter vs. fistula, and start of week vs. mid-week were negatively associated.

Conclusions: Dialysis center policy in terms of blood flow, treatment time, filter size, and perhaps even hemoglobin targets plays a key role in achieving high-volume HDF. All of these are modifiable factors that can help in prescribing an optimal combination of dialyzer size, achievable blood flows, and treatment times.

Data 11.06.2015
 
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