Lucile Mercadal, Aziz Hamani, Bernard Béné, Thierry Petitclerc

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Presentation transcript:

Determination of access blood flow from ionic dialysance: Theory and validation Lucile Mercadal, Aziz Hamani, Bernard Béné, Thierry Petitclerc Kidney International Volume 56, Issue 4, Pages 1560-1565 (October 1999) DOI: 10.1046/j.1523-1755.1999.00679.x Copyright © 1999 International Society of Nephrology Terms and Conditions

Figure 1 Blood flows without access recirculation. Vascular access blood flow (QA) is usually higher than blood flow at the dialyzer inlet (QB). In these conditions, no recirculation occurs. Kidney International 1999 56, 1560-1565DOI: (10.1046/j.1523-1755.1999.00679.x) Copyright © 1999 International Society of Nephrology Terms and Conditions

Figure 2 Blood flows with access recirculation. If QA < QB, recirculation occurs with: QR = QB – QA. The rate of solute delivered to the dialyzer can be expressed as follows:(Eq. 1) Kidney International 1999 56, 1560-1565DOI: (10.1046/j.1523-1755.1999.00679.x) Copyright © 1999 International Society of Nephrology Terms and Conditions

Figure 2 Blood flows with access recirculation. If QA < QB, recirculation occurs with: QR = QB – QA. The rate of solute delivered to the dialyzer can be expressed as follows:(Eq. 1) Kidney International 1999 56, 1560-1565DOI: (10.1046/j.1523-1755.1999.00679.x) Copyright © 1999 International Society of Nephrology Terms and Conditions

Figure 3 Recirculation with blood lines in reversed position. The recirculation ratio is a function of QA. The solute conservation at point M can be expressed as follows:(Eq. 3) Kidney International 1999 56, 1560-1565DOI: (10.1046/j.1523-1755.1999.00679.x) Copyright © 1999 International Society of Nephrology Terms and Conditions

Figure 3 Recirculation with blood lines in reversed position. The recirculation ratio is a function of QA. The solute conservation at point M can be expressed as follows:(Eq. 3) Kidney International 1999 56, 1560-1565DOI: (10.1046/j.1523-1755.1999.00679.x) Copyright © 1999 International Society of Nephrology Terms and Conditions

Figure 4 Comparison of access flow rate values measured using the Diascan® (QA-ID) and the HD01® monitor (QA-US). Kidney International 1999 56, 1560-1565DOI: (10.1046/j.1523-1755.1999.00679.x) Copyright © 1999 International Society of Nephrology Terms and Conditions

Figure 5 Bland-Altman plot between access flow rate values measured by the Diascan® (QA-ID) and by HD01® monitor (QA-US). Kidney International 1999 56, 1560-1565DOI: (10.1046/j.1523-1755.1999.00679.x) Copyright © 1999 International Society of Nephrology Terms and Conditions

Figure 6 A device for reversing the blood lines. When crossed lines are clamped (as in the photograph), blood lines are in a normal position. When external lines are clamped, the blood lines are reversed. Kidney International 1999 56, 1560-1565DOI: (10.1046/j.1523-1755.1999.00679.x) Copyright © 1999 International Society of Nephrology Terms and Conditions