Analysis of the optical concentration curve to detect access recirculation.

The optical blood volume curve sometimes presents either a positive or a negative rapid and reversible variation (spike) during the step of the dialysate conductivity, automatically set by the monitor for the ionic dialysance (ID) measurement. We studied whether this feature was in relation with access recirculation. Firstly, we studied if the manoeuvre of reversed position of the blood lines created the same feature in the blood volume curve.

[Performance of central catheters on the filtration yield measured by ionic dialysance ].

Certain number of dysfunctions, particularly decline of blood flow or, recirculation, can decrease the adequacy of depuration, when central catheters are used. Ionic dialysance is available on some monitors (Integra), and reflects perfectly the effective urea clearance, permits to watch any variation in the effective clearance of the depuration system due to these dysfunctions. We report on our experience in a retrospective study from 01/01/2000 to 30/11/2000 where we compared the effective clearance of depuration measured by the ionic dialysance of all the sessions of dialysis made on central catheters in our center, with the forecast clearance of sessions made in the same conditions of dialysis but with a non pathologic fistula.

[Ionic dialysance and quality control in hemodialysis].

Quantification of dialysis is based on the measurement of effective urea clearance (K), dialysis dose (Kt) or normalized dialysis dose (Kt/V). During the last 20 years, Kt/V was the single parameter actually useful for quantifying dialysis efficiency, because it can be calculated from just blood or dialysate urea concentrations at the beginning and at the end of the dialysis session. However the calculation of the normalized dialysis dose (Kt/V) actually delivered to the patient cannot be performed during each dialysis session, because of the need of urea concentration measurements.

[Factors determining the choice of a modality of treatment by dialysis: a study of nine dialysis centers].

Background: The objective of this cross-sectional study in a population of 1472 dialysis patients was to identify the main factors involved in the choice of a specific option for dialysis therapy, taking into account three different types of criteria such as medical dependence (DM), nurse care requirement (SI) and independence for dialysis therapy (CA).

Methods: Each patient has been analysed, independently of present treatment modality, according to the above three criteria, namely DM, SI and CA. For each type of parameter, patients have been allocated to one of three levels, each level being established to evaluate whether dialytic treatment should be undertaken as hospital centre dialysis (HDC) or in a facility off the hospital.