Work

Smart, Individualized Green Hemodiafiltration ‐ Effects of Individualized Dialysate Flow Through AutoFlow on Dialysate Consumption and Parameters of Dialysis Adequacy in the Setting of Online Hemodiafiltration

Year: 2025

Type: article

Abstract: ABSTRACT Introduction High‐dose online HDF compared with hemodialysis reduces all‐cause mortality, but increases water consumption. We postulate that the conundrum could be solved by individualizing dialysate flow. Methods Thirty CKD5D patients undergoing online HDF post‐dilution were changed from fixed dialysate flow (500 mL/min) to individualized dialysate flow, resulting in a dialysate flow that was always 20% higher than the blood flow. Kt / V urea , K + , Phos, and pill burden in one quater pre as well as four quarters after the change were evaluated. Results The practice change resulted in a reduction of the fixed dialysate flow from 500 to 360 (240–383) mL/min. Parameters of dialysis adequacy did not change; neither did the medication. Conclusion An individualization of the dialysate flow saved about 36 L dialysate per session; hence, even in light of 23 L used for online HDF, the net burden on the environment could be reduced. Neither dialysis adequacy nor pill burden was negatively affected.

Source: Therapeutic Apheresis and Dialysis

DOI: 10.1111/1744-9987.70072

Authors: Vanessa David, Bastian Au, Torsten M. Meyer, Kijanosh Lehmann, Jan T. Kielstein

Institution: Klinikum Braunschweig

Language: English

Topic: Dialysis and Renal Disease Management

Subfield: Nephrology

Field: Medicine

Domain: Health Sciences

SDGs: Good health and well-being, Responsible consumption and production

Open Access status: hybrid

Estimated APC paid: $3,350