Chinese Journal of Blood Purification

Chinese Journal of Blood Purification ›› 2022, Vol. 21 ›› Issue (07): 507-511,540.doi: 10.3969/j.issn.1671-4091.2022.07.010

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Multicentre Analysis of Clinical Characteristics in Maintenance Hemodialysis Patients with Inadequate Dialysis

  

  1. Department of Nephrology, Peking University People's Hospital, Beijing 100044, China; Department of Nephrology, Beijing Luhe Hospital, Capital Medical University, Beijing 101100, China; Department of Nephrology, Beijing
    Miyun District Hospital, Beijing 101500, China;      Jiaozhou Bethune Blood Purification Center, Jiaozhou
    266300, China;      Department of Nephrology, China Rehabilitation Research Center, Beijing Bo Ai Hospital,
    Beijing 100068, China;      Department of Nephrology, Chui Yang Liu Hospital Affiliated to Tsinghua University,
    Beijing 100022, China;      Department of Nephrology, Beijing Changping District Hospital, Beijing
    102200,China;      Department of Nephrology, Beijing Shijingshan Hospital, Beijing 100040, China;  Blood Purification Center, Beijing Zhanlanlu Hospital, Beijing 100044, China;  Blood Purification Center, Department
    of Nephrology, Peking University International Hospital, Beijing 102206, China
  • Received:2022-02-03 Revised:2022-05-09 Online:2022-07-12 Published:2022-07-12

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Abstract: Objective The purpose of this study was to investigate the clinical characteristics of inadequate dialysis in hemodialysis patients, so as to provide the evidences for improving clinical diagnosis and
treatment of inadequate dialysis and promoting dialysis adequacy. Methods This study was a multi- center
and cross-sectional survey. We retrospectively analyzed the patients with the single pool Kt/V (spKt/V) <1.2 in
a measurement during January to March 2018 from 12 centers. Their demographic, treatment prescription, actual treatment and residual renal function data were collected and analyzed. SPSS 22.0 statistical software was
used for data analysis, and Spearman correlation analysis was used to test the correlation between body
weight after dialysis, blood flow rate (BFR), and weight-normalized BFR. Results A total of 224 patients
were enrolled in this study. Their average age was 58.2±13.3 years, and the male to female ratio was 5.2:1.
The prescribed spKt/V was 1.39±0.29, and the measured spKt/V was 1.06±0.11. In the 117 (52.2%) patients
whose prescribed Kt/V was <1.4, the KoA of dialyzer (t=-8.619, P<0.001), BFR (t=-3.846, P＜0.001) and
weight-normalized BFR (t=-12.577, P＜0.001) were significantly lower than those in spKt/V ≥1.4 group. In
the 224 patients, weight-normalized BFR decreased gradually with the increase of body weight (ρ=-0.666, P<
0.001). There were 42 patients (18.8%) whose dialysis time was less than 240min, and 35 patients (15.6%)
with blood coagulation in dialyzer. Residual native kidney function was present in 87 patients (38.84%); 14 of
the 87 patients were tested for residual renal function, of which 5 patients fulfilled the standard Kt/V after combination of the Kt/V values from residual renal function and dialysis. Conclusion Insufficient dialysis in hemodialysis patients may relate to the lower prescribed Kt/V, lower weight-normalized BFR, shorter dialysis
time, blood coagulation in dialyzer, unreasonable calculation methods for dialysis adequacy, and acute complications during hemodialysis sessions.

Key words: Maintenance hemodialysis, Dialysis adequacy, Blood flow rate, Residual native kidney function

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