EFFECT OF THE DIRECTION OF DIALYSATE FLOW ON THE EFFICIENCY OF CONTINUOUS ARTERIOVENOUS HEMODIALYSIS

被引：21
作者：
DAVENPORT, A
WILL, EJ
DAVISON, AM
机构：
[1] Department of Renal Medicine, St. James’s University Hospilal, Leeds
来源：
BLOOD PURIFICATION | 1990年 / 8卷 / 06期
关键词：
CONTINUOUS ARTERIOVENOUS HEMODIALYSIS; DIALYSATE; CONCURRENT FLOW; COUNTERCURRENT FLOW;
D O I：
10.1159/000169987
中图分类号：
R5 [内科学];
学科分类号：
1002 ; 100201 ;
摘要：
We have investigated the effect of the direction of the dialysate flow during continuous arteriovenous haemodialysis. Under similar conditions countercurrent flow was more efficient than concurrent flow in terms of both urea clearance (mean +/- SEM), 23.5 +/- 0.5 compared to 18.4 +/- 0.4 ml/min (p < 0.001) and creatinine clearance, 21.1 +/- 0.5 compared to 15.6 +/- 0.4 ml/min (p < 0.001). There was a greater drop in pressure along the blood compartment of the haemodiafilter during countercurrent flow, 16 +/- 0.8 compared to 13 +/- 0.3 mm Hg (p < 0.05) during concurrent flow, and this was associated with a greater ultrafiltration rate, 7.2 +/- 0.6 compared to 6.0 +/- 0.5 ml/min. The differences in diffusion, back diffusion and convection between the two systems resulted in a net gain of lactate/bicarbonate and a net loss of chloride during countercurrent dialysate flow, and a net loss of lactate/bicarbonate with a gain of chloride during concurrent flow. These losses would have to be corrected in the clinical setting of patients who had been continuously treated by these systems for several days.
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页码：329 / 336
页数：8
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