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BMC Nephrology

, 9:15

First Online: 24 November 2008Received: 10 August 2008Accepted: 24 November 2008


BackgroundIn hemodialysis, extracorporeal blood flow Qb recommendation is 300–500 mL-min. To achieve the best Qb, we based our prescription on dynamic arterial line pressure DALP.

MethodsThis prospective study included 72 patients with catheter Group 1 G1, 1877 treatments and 35 arterio-venous AV fistulae Group 2 G2, 1868 treatments. The dialysis staff was trained to prescribe Qb sufficient to obtain DALP between -200 to -250 mmHg. We measured ionic clearance IK: mL-min, access recirculation, DALP mmHg and Qb mL-min. Six prescription zones were identified: from an optimal A zone Qb > 400, DALP -200 to -250 to zones with lower Qb E Qb < 300, DALP -200 to -250 and F Qb < 300, DALP > -199.

ResultsTreatments distribution in A was 695 37% in G1 vs. 704 37.7% in G2 P = 0.7. In B 150 8% in G1 vs. 458 24.5% in G2 P < 0.0001. Recirculation in A was 10.0% Inter quartile rank, IQR 6.5, 14.2 in G1 vs. 9.8% IQR 7.5, 14.1 in G2 P = 0.62. IK in A was 214 ± 34 G1 vs. 213 ± 35 G2 P = 0.65. IK Anova between G2 zones was: A vs. C and D P < 0.000001. Staff prescription adherence was 81.3% G1 vs. 84.1% G2 P = 0.02.

ConclusionIn conclusion, an optimal Qb can de prescribed with DALP of -200 mmHg. Staff adherence to DLAP treatment prescription could be reached up to 81.3% in catheters and 84.1% in AV fistulae.

Electronic supplementary materialThe online version of this article doi:10.1186-1471-2369-9-15 contains supplementary material, which is available to authorized users.

Franklin G Mora-Bravo, Alfonso Mariscal, Juan P Herrera–Felix, Salvador Magaña, Guadalupe De-La-Cruz, Nelly Flores, Laura Rosales, Martha Franco and Héctor Pérez-Grovas contributed equally to this work.

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Autor: Franklin G Mora-Bravo - Alfonso Mariscal - Juan P Herrera–Felix - Salvador Magaña - Guadalupe De-La-Cruz - Nelly Flores


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