1 2012 Vol: 15(3). DOI: 10.4321/S2254-28842012000300005

Comparison of the dialysis efficacy between two reinfusion control systems in online haemodiafiltration

The dose of dialysis and the volume of reinfusión are key elements in the best results communicated in the hemodiafiltration online. Technological advances allow two forms of automated control of reinfusion volume (a volume-based and a pressure-based control system), and two methods of measuring Kt obtained by ionic dialysance (OCM and Diascan). The purpose of this study was to compare both these control systems. We designed a prospective, crossover study of the prevalent population in post-dilution on-line hemodiafiltration, with explicit consent. For 2 consecutive weeks, three sessions were performed with automatic reinfusion according to hematocrit and total protein values and Kt measurement with OCM, and three sessions were performed with automatic reinfusion according to transmembrane pressure and Kt measurement with Diascan. The average reinfusion volume and Kt were compared. Variables were contrasted with Student's t-test for related samples. Statistical significance was set at p <0.05. Sixteen patients concluded the study (56% men, with a mean age of 58.8 years). A total of 81.3% had autologous or prosthetic fistulas for vascular access. Reinfusion volume was significantly higher (p = 0.029) under pressure control (23.24 ± 2.55 lversus 21.81 ± 1.75 l) while Kt measured by OCM was significantly (p <0.001) higher than that measured by Diascan (59.94 ± 5.05 l versus 55.12 ± 4.15 l. We found a 6.2% increase in volume reinfusion under pressure control, although both methods performed well in the final convective transport liters. The dialysis dose (Kt) was higher when OCM was used.

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