The Clinical Appraise Of Online Clearance Measurement

Objective: To evaluate the efficiency and safety of online clearance measurement (OCM).and refer a continuous, effective way to assess the hemodialysis adequacy. And refer data for JH hemodialysis machines.Method: Twenty-eight patients with maintenance hemodialysis were enrolled on Fresenius4008S machine and OCM appliance. Meanwhile, plasma Cr and blood urea nitrogen (BUN) of the patient pre-and post-dialysis were examined. Kt/V by OCM , by calculation and urea reduction rate(URR) were compared between group with different dialyzer refuse time, different ultrafiltration volume ,different body surface area .The changes of sodium concentration, blood pressure, heart rate, breathing rate, the subjective symptom between pre- dialysis and post-dialysis, OCM running process and non- OCM process were observed.Result: There is highly correlation between Kt/V by OCM and by calculation r=0.48.Different dialyzer refuse time and different ultrafiltration volume have little affects to the hemodialysis adequacy (p>0.05) .The Kt/V was significant different between group A (body surface area≥ 1.73m2) and group B (body surface area <1.73m2), p<0.05, but the URR between the two group was not significant different. The changes of sodium concentration, blood pressure, heart rate, breathing rate ,the subjective symptom between pre-dialysis and post-dialysis (p>0.05), OCM running process and non-OCM process (p>0.05)were was not significant different. The blood flow, height, weight have more effect to hemodialysis adequacy than age, ALB and HCT.Conclusion: The OCM option of hemodialysis machine provides a safe and accurate tool for continuous online monitoring of total urea clearance. And so we can adjust hemodialysis project in time.