Abstract: TH-PO256
Enhanced Dialysis Efficiency through Reverse Filtration in a Novel Single-Needle Dialysis System: A Pilot Study
Session Information
- Hemodialysis, Hemodiafiltration, and Frequent Dialysis
October 24, 2024 | Location: Exhibit Hall, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Dialysis
- 801 Dialysis: Hemodialysis and Frequent Dialysis
Author
- Kawanishi, Hideki, Tsuchiya Sogo Byoin, Hiroshima, Japan
Background
As the population of elderly dialysis patients increases, addressing vascular access issues becomes paramount. The single needle dialysis system (SN) has emerged as a potential solution, yet its efficacy is hampered by inadequate blood flow and recirculation. This study introduces a novel approach utilizing reverse filtration to enhance solute removal efficiency in single needle dialysis (NSN).
Methods
Building upon automated dialysis principles (on-line HDF system, GG-X01, JMS, Co. Japan), the system alternates between ultrafiltration and reverse filtration to optimize treatment outcomes
The process of NSN repeats itself: guiding circulating, returning and circulating of blood. Blood is constantly circulated, and during the guiding process, the ultrafiltration pump is rotated to filter the blood until a set amount of guiding is achieved. Subsequent circulation agitates the blood in the circuit and diffuses substances. In the return phase, the ultrafiltration pump is reversed and returned to the circuit (Figure).
A two-armed crossover pilot study of NSN vs SN involving five patients evaluated the system's efficacy compared to conventional methods. Dialysis efficiency was evaluated by measuring the solute of urea, and β2microglobulin (BMG) removal rate (RR), the amount removal volume (RV) into the spend dialysate and Kt/Vurea.
Results
Blood flow rate 250mL/min, Dialysate flow rate 500mL/min, 4 hour and dialyzer NVF26H (Tore Co, Japan) were sated. Mean Kt/Vurea 1.26, RR (urea 66.3, BMG 70.2%) and RV(urea 8.4g, BMG 23.5mg) at NSN, an increase over SN was obtained.
Conclusion
Newly development of single needle system used reverse filtration creased dialysis efficiency, especially for middle molecule. However, further study is needed to improve the efficiency of the system.