Mp634haemodiafiltration Relative Infection Risk: A Comparative Analysis of Two Dialysis Machines

Tsobanelis, Theoharis; Hensel, Norbert; Kollia, Maria; Sierp, Oliver; Kurz, Peter

doi:10.1093/ndt/gfw198.51

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“…The risk of harm has to be reduced as much as possible, and one option is to reduce this risk by the improved design of the equipment. As an example, we can again mention the recent experience of Tsobanelis et al [28], who reported that the tested new equipment had 27% fewer major process steps and touch points critical to hygiene compared to the current machine version. The authors found it particularly noteworthy that it was possible to avoid disconnection of the arterial line from the arterial needle with the redesigned process of blood reinfusion at the end of the session.…”

Section: Other Machine-related Variablesmentioning

confidence: 92%

Update on Clinical Evidence Supporting Hemodiafiltration

Canaud¹,

Grassmann²,

Scatizzi³

et al. 2016

Advances in Hemodiafiltration

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The aim of this chapter is to define hemodiafiltration target efficiency, to clarify the concept of "optimal convective dose," and to facilitate hemodiafiltration (HDF) implementation in clinical practice by addressing the need for the establishment of best clinical practices for HDF. The approach taken was to conduct a comprehensive summary of clinical evidence supporting HDF. Convective dose is the total ultrafiltered volume and is complementary to diffusive dose (urea Kt/V) as a dose-dependent parameter. It can be quantified and adjusted to patient characteristics. Factors affecting convective dose are discussed: patient characteristics, prescription-dependent factors, and technical and machine-dependent factors. The key issue of HDF prescription and implementation of best practices is addressed as are intermediary and endpoint clinical outcomes. The main messages are as follows: (1) HDF is safe and effective provided that best clinical practices are followed and the right convective dose is delivered; (2) HDF is easy to perform with new technology; and (3) depending on the convection volume, HDF reduces all-cause and cardiovascular mortality. Open challenges remain, namely, the implementation of best practices to (a) achieve optimal convection volume, (b) define patient subsets that would benefit more from HDF, and (c) evaluate new tools that fine-tune HDF prescription according to individual patient needs.

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Section: Other Machine-related Variablesmentioning

confidence: 92%