Rapid accelerated hemodialysis in children with end-stage renal disease: A randomized clinical trial
In rapid accelerated hemodialysis (R-AHD), blood partially recirculates from the venous (outflow) to the arterial (inflow) line through a recirculation line (R) to selectively increase the filter blood flow rate (BFR). R-AHD PR uses two blood pump segments at the patient segment of the arterial line...
| Main Authors: | , , |
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| Format: | Article |
| Language: | English |
| Published: |
Wolters Kluwer Medknow Publications
2013-01-01
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| Series: | Saudi Journal of Kidney Diseases and Transplantation |
| Online Access: | http://www.sjkdt.org/article.asp?issn=1319-2442;year=2013;volume=24;issue=1;spage=22;epage=29;aulast=El |
| _version_ | 1818012065493680128 |
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| author | Mohamed Khaled El Hatw Fatina Fadel Ramzy El Baroudy |
| author_facet | Mohamed Khaled El Hatw Fatina Fadel Ramzy El Baroudy |
| author_sort | Mohamed Khaled El Hatw |
| collection | DOAJ |
| description | In rapid accelerated hemodialysis (R-AHD), blood partially recirculates from the venous (outflow) to the arterial (inflow) line through a recirculation line (R) to selectively increase the filter blood flow rate (BFR). R-AHD PR uses two blood pump segments at the patient segment of the arterial line and at (R). To determine the effectiveness of R-AHD with regard to increasing anticoagulation and dialysis efficiency, we studied ten children with end-stage renal disease in two stages: stage 1 with 10 routine heparin R-AHD, then 10 half-dose heparin R-AHD, then 145 routine heparin R-AHD sessions for 1 month and then routine heparin double needle hemodialysis (DNHD) for one month (control). In stage 2, we dialyzed the patients with 10 routine heparin-mixed AHD PR and DNHD sessions, then eight low-dose heparin R-AHD PR" sessions, then one of the children with 10 no-heparin R-AHD PR sessions and then 10 routine heparin DNHD sessions" (control). Signs of blood clotting and dialysis efficiency were monitored. Blood clots appeared in four out of 165 R-AHD 0 (one pump circuit) sessions but in none of the 28 R-AHD PR sessions. In stage 1, the mean urea reduction rate was 0.60, 0.60 and 0.70 for the R-AHD protocols, compared with 0.71 for the control (P >0.05). In stage 2, the arterial blood urea nitrogen was reduced by 0.66 ± 0.15 after an R-AHD PR period, compared with 0.79 ± 0.18 after a DNHD period (P = 0.059). In conclusion, R-AHD PR allowed successful low heparin and no heparin hemodialysis in children without increasing the patients′ BFR. However, the technique did not increase the efficiency of dialysis. |
| first_indexed | 2024-04-14T06:16:18Z |
| format | Article |
| id | doaj.art-d51744043c064cbc88f94b999360433f |
| institution | Directory Open Access Journal |
| issn | 1319-2442 |
| language | English |
| last_indexed | 2024-04-14T06:16:18Z |
| publishDate | 2013-01-01 |
| publisher | Wolters Kluwer Medknow Publications |
| record_format | Article |
| series | Saudi Journal of Kidney Diseases and Transplantation |
| spelling | doaj.art-d51744043c064cbc88f94b999360433f2022-12-22T02:08:12ZengWolters Kluwer Medknow PublicationsSaudi Journal of Kidney Diseases and Transplantation1319-24422013-01-01241222910.4103/1319-2442.106233Rapid accelerated hemodialysis in children with end-stage renal disease: A randomized clinical trialMohamed Khaled El HatwFatina FadelRamzy El BaroudyIn rapid accelerated hemodialysis (R-AHD), blood partially recirculates from the venous (outflow) to the arterial (inflow) line through a recirculation line (R) to selectively increase the filter blood flow rate (BFR). R-AHD PR uses two blood pump segments at the patient segment of the arterial line and at (R). To determine the effectiveness of R-AHD with regard to increasing anticoagulation and dialysis efficiency, we studied ten children with end-stage renal disease in two stages: stage 1 with 10 routine heparin R-AHD, then 10 half-dose heparin R-AHD, then 145 routine heparin R-AHD sessions for 1 month and then routine heparin double needle hemodialysis (DNHD) for one month (control). In stage 2, we dialyzed the patients with 10 routine heparin-mixed AHD PR and DNHD sessions, then eight low-dose heparin R-AHD PR" sessions, then one of the children with 10 no-heparin R-AHD PR sessions and then 10 routine heparin DNHD sessions" (control). Signs of blood clotting and dialysis efficiency were monitored. Blood clots appeared in four out of 165 R-AHD 0 (one pump circuit) sessions but in none of the 28 R-AHD PR sessions. In stage 1, the mean urea reduction rate was 0.60, 0.60 and 0.70 for the R-AHD protocols, compared with 0.71 for the control (P >0.05). In stage 2, the arterial blood urea nitrogen was reduced by 0.66 ± 0.15 after an R-AHD PR period, compared with 0.79 ± 0.18 after a DNHD period (P = 0.059). In conclusion, R-AHD PR allowed successful low heparin and no heparin hemodialysis in children without increasing the patients′ BFR. However, the technique did not increase the efficiency of dialysis.http://www.sjkdt.org/article.asp?issn=1319-2442;year=2013;volume=24;issue=1;spage=22;epage=29;aulast=El |
| spellingShingle | Mohamed Khaled El Hatw Fatina Fadel Ramzy El Baroudy Rapid accelerated hemodialysis in children with end-stage renal disease: A randomized clinical trial Saudi Journal of Kidney Diseases and Transplantation |
| title | Rapid accelerated hemodialysis in children with end-stage renal disease: A randomized clinical trial |
| title_full | Rapid accelerated hemodialysis in children with end-stage renal disease: A randomized clinical trial |
| title_fullStr | Rapid accelerated hemodialysis in children with end-stage renal disease: A randomized clinical trial |
| title_full_unstemmed | Rapid accelerated hemodialysis in children with end-stage renal disease: A randomized clinical trial |
| title_short | Rapid accelerated hemodialysis in children with end-stage renal disease: A randomized clinical trial |
| title_sort | rapid accelerated hemodialysis in children with end stage renal disease a randomized clinical trial |
| url | http://www.sjkdt.org/article.asp?issn=1319-2442;year=2013;volume=24;issue=1;spage=22;epage=29;aulast=El |
| work_keys_str_mv | AT mohamedkhaledelhatw rapidacceleratedhemodialysisinchildrenwithendstagerenaldiseasearandomizedclinicaltrial AT fatinafadel rapidacceleratedhemodialysisinchildrenwithendstagerenaldiseasearandomizedclinicaltrial AT ramzyelbaroudy rapidacceleratedhemodialysisinchildrenwithendstagerenaldiseasearandomizedclinicaltrial |