Sage Journals: Discover world-class research

Abstract

Correction of the acid-base balance in uremic patients during hemodiafiltration (HFD) may be biased by an inadequate monitoring of phi and blood gases. HDF performed with the two-chamber technique (PFD) generates pure ultrafiltrate (uf) unmixed with dialysate. We carried out 84 determinations of HCO⁻₃ levels in 15 different PFD patients by measuring the pH and pCO₂ of the uf, then correlated the values with those simultaneously evaluated on arterial blood with standard methods. The mean HCO⁻₃ levels (mmol/L) were 23.21±2.49 in blood samples and 25.54±3.07 in uf, with a mean difference of -2.33±1.46. Statistical analysis gave: t=13.5 (p=O) (one-sample analysis), r=0.86 (p=0) (linear regression analysis) and a good agreement between the two clinical measurements (81 out of 84 data points fell within the 95% confidence interval) (Bland-Altman analysis). In conclusion, we suggest that during HDF performed with the two-chamber technique, the patient's HCO⁻₃ level can be monitored on the uf without blood sampling.

Keywords

Hemodialysis PFD (paired filtration dialysis)Acid-base balance Acid-base monitoring

Get full access to this article

View all access options for this article.

References

Ghezzi

P.M.

, Frigato

, Fantini

Theoretical model and first clinical results of the paired filtration dialysis (PFD).

Life Support Systems 1983; 1(supp. 1): S271–4.

Ghezzi

P.M.

, Sanz-Moreno

, Gervasio

Technical requirement for rapid high efficiency therapy in uraemic patients: answer by PFD with two-chamber technique.

Trans Am Soc Artif Intern Organs 1987; 33: 546–50.

Ghezzi

P.M.

, Dutto

, Gervasio

, Botella

. Hemodiafiltration with separate convection and diffusion: paired filtration dialysis. Contr Nephrol 1989; 69: 141–61.

Ronco

, Feriani

, Chiaromonte

Paired Filtration dialysis: studies on efficiency, flowdynamics and hydraulic properties of the system.

Blood Purif 1990; 8: 126–40.

Botella

, Ghezzi

P.M.

, Sanz-Moreno

Multicentric study on PFD as a short highly efficient dialysis technique.

Nefrologia 1991; 11: 234–41.

Zucchelli

, Botella

Spongano M,

Paired filtration dialysis: optimizing depurative efficiency with separate convection and diffusion processes.

Nephron 1990; 56: 166–73.

Vanholder

, De Smet

, Gervasio

, Ringoir

. In vivo solute elimination of paired filtration dialysis. Int J Artif Organs 1991; 14: 23–7.

Ronco

. Paired filtration dialysis: una tecnica in evoluzione. Giorn It Nefrol 1994; 11: 1–6 (Editoriale).

Henderson

L.W.

, Quallhorst

E.A.

, Baldamus

C.A.

, Lysaght (eds). Hemofiltration. Springer-Verlag, Berlin 1986.

10.

Spongano

, Santoro

, Ferrari

Urea kinetic assessment using only ultrafiltrate urea concentration in a two-chamber technique (PFD).

Nephrol Dial Transplant 1990; 8: 716 (abstract).

11.

Tetta

. Continuous on-line monitoring in PFD. European Dial Transpl Ass Meeting, Glasgow 1993 (Abstract).

12.

Ghezzi

P.M.

, Gervasio

, Botella

. Continuous pH and HC03 monitoring during hemodiafiltration without blood sampling. Trans Am Soc Artif Intern Organs 1991; 37: 605–7.

13.

Agazia

, Guarda

, Lombini

, Saporiti

. Continuous transcutaneous gas monitoring in adults on regular dialysis treatment. Int J Artif Organs 1989; 2: 103–10.

14.

Bland

J.M.

, Altman

D.G.

. Statistical methods for assessing agreement between two methods of clinical measurement. Lancet 1986; february 8: 307–10.

15.

Ghezzi

M.P.

, Guarnieri

, Tetta

. Validazione della determinazione via ultrafiltrato dell'equilibrio acido-base in corso di emodiafiltrazione con tecnica PFD. Giorn It Nefrol 1994 (in press).

Acid-Base Balance Determination on Ultrafiltrate in Two-Chamber Technique Hemodiafiltration (PFD)

Abstract

Keywords

Get full access to this article

References