RISK OF INADEQUATE DIALYSIS DOSE IN HEMODIALYSIS PATIENTS WITH HIGH WATSON VOLUME

Secundino Cigarrán MD, Francisco Coronel MD,Phd, Jaime Torrente MD, Montserrat Sevilla MD, José Carlos Diez Baylón MD.

Unidad Nefrológica Moncloa. Fresenius Medical Care. Madrid. Spain
cigarran@ctv.es

Quality control of dialysis treatment has received wide attention since inadequate dialysis dose was an independent risk factor of morbidity and mortality in hemodialysis patients. Each 0.1decrease in kt/v less than 1.2 is estimated to increase the relative risk of death by 5-7%.

A higher Kt/v can be achieved by incresing treatment time, using a larger dialyzer or incresing blood or dialysate flow rates. However large patients are suspected at risk for inadequate dialysis dose. Confirm this hypothesis was the aim of this cross-sectional study using OCM routinaly.

24 anuric pts were included in a cross-sectional study, 20.8% were diabetics, mean age 64.7± 18.2 yo, 16% females. Access blood were AVFi and the effective dialysed blood flow was set at 350 ml/min, with recirculation <5% . BMI 25.4 ± 3.8 kg/m2, body weight 69.7 ± 12 kg. All pts were dialysed thrice weekly, 245 ± 21 min, with dialysis machine 4008H (Fresenius Medical Care) equiped with OCM monitor, and the hollow fibre high-flux polysulfone membrane ( HF-80 S 1.8 m2) and helixone (Fx-60s, 1.6 m2). Dialysate flow was maintained at 500 ml/min, with standard dialysate liquid.. Drug therapy was not varied. OCM was validate for our population and reported in other abcstract (r²= 0.96, p<0.001).

Data were processed and statistically analyzed with SPSS 11.0 software package. Watson volume to other baseline characteristics was assessed by using contingency tables, t-tests, analysis of variance, linear regression, as appropiate. All the test were performed for a 0.05 significance level.

The OCM-kt/v was inversely related to Watson Volume ( r= - .833, p< 0.001).