A study on the accuracy of an ultrafiltration control system: Causes of excessive ultrafiltration by a high flux membrane dialyzer.:Causes of excessive ultrafiltration by a high flux membrane dialyzer

概要

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We experienced highly excessive ultrafiltration (EUF) in patients on high flux membrane dialyzers despite using consoles with an ultrafiltration control system (UFC). We found that the degree of EUF was correlated with the frequency of the alarm for dialysate positive pressure (DPP) during dialysis. To confirm and clarify the causes of this phenomenon, we performed in vivo and in vitro studies as described below. 1. We checked EUF and alarm frequency for DPP in three patients on the same dialysis console (Nikkiso DCS-22) for 10 consecutive dialyses. In each patient, degree of EUF was significantly correlated with the frequency of the DPP alarm. The degree of EUF was greater in patients on high-flux membrane dialyzers than on conventional cuprophane membrane dialyzers. 2. We measured the degree of OF leakage through the solenoid electromagnetic valve (SV) between the time the DPP alarm sounded and the time dialysis was restarted under various conditions in vitro. The degree of leakage through the SV during dialysate flow stoppage was significantly correlated with time until dialysis was restarted, the UFR of the dialyzers, DPP at the time of the alarm and venous pressure in the blood line.We concluded that a large EUF occurs as a result of leakage of UF through the SV during dialysate flow stoppage as a result of the DDP alarm when high flux membrane dialyzers are used on UFC consoles.
社団法人日本透析医学会の論文