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Comparison of progressive conductivity reduction with diacontrol and standard dialysis.
ASAIO J. 2007 Mar-Apr; 53(2):194-200.AJ

Abstract

We examined whether progressive reduction of dialysate sodium with Diacontrol (DC, plasma conductivity targeted feedback system) confers any clinical benefit over a similar strategy using dialysis with fixed dialysate conductivity (HD). Ten stable patients entered a randomized crossover study conducted over 360 dialysis sessions. Sodium balance, blood pressure (BP), intradialytic hypotension rates (IDH), thirst score, and extracellular water (ECW) were recorded. Interdialytic ambulatory BP was measured at the highest and lowest conductivities. BP, interdialytic weight gains and thirst scores were low at the outset and were not altered significantly by conductivity reduction. The lowest fixed dialysate setting of 13.2 mS/cm resulted in greater sodium depuration than the lowest conductivity setting allowable with DC, as reflected by lower post dialysis plasma conductivity (13.4 +/- 0.14 mS/cm versus 13.5 +/- 0.04 mS/cm, p < 0.001). Predialysis ECW fell from 0.22 +/- 0.04 l/kg to 0.21 +/- 0.09 l/kg as conductivity reduced with HD (p < 0.05), but did not change significantly with DC. When HD and DC were matched for end-dialysis plasma conductivity, there were no differences in BP, IDH frequency, or dialysis tolerability even at the lowest conductivity settings. In a setting of dialysate sodium reduction, DC did not appear to have any short-term clinical advantage over standard dialysis, and its range is limited at the lower conductivity settings.

Authors+Show Affiliations

Department of Renal Medicine, Derby City Hospital, Derby, UK.No affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Randomized Controlled Trial

Language

eng

PubMed ID

17413560

Citation

Selby, Nicholas M., et al. "Comparison of Progressive Conductivity Reduction With Diacontrol and Standard Dialysis." ASAIO Journal (American Society for Artificial Internal Organs : 1992), vol. 53, no. 2, 2007, pp. 194-200.
Selby NM, Taal MW, McIntyre CW. Comparison of progressive conductivity reduction with diacontrol and standard dialysis. ASAIO J. 2007;53(2):194-200.
Selby, N. M., Taal, M. W., & McIntyre, C. W. (2007). Comparison of progressive conductivity reduction with diacontrol and standard dialysis. ASAIO Journal (American Society for Artificial Internal Organs : 1992), 53(2), 194-200.
Selby NM, Taal MW, McIntyre CW. Comparison of Progressive Conductivity Reduction With Diacontrol and Standard Dialysis. ASAIO J. 2007 Mar-Apr;53(2):194-200. PubMed PMID: 17413560.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Comparison of progressive conductivity reduction with diacontrol and standard dialysis. AU - Selby,Nicholas M, AU - Taal,Maarten W, AU - McIntyre,Christopher W, PY - 2007/4/7/pubmed PY - 2007/5/3/medline PY - 2007/4/7/entrez SP - 194 EP - 200 JF - ASAIO journal (American Society for Artificial Internal Organs : 1992) JO - ASAIO J VL - 53 IS - 2 N2 - We examined whether progressive reduction of dialysate sodium with Diacontrol (DC, plasma conductivity targeted feedback system) confers any clinical benefit over a similar strategy using dialysis with fixed dialysate conductivity (HD). Ten stable patients entered a randomized crossover study conducted over 360 dialysis sessions. Sodium balance, blood pressure (BP), intradialytic hypotension rates (IDH), thirst score, and extracellular water (ECW) were recorded. Interdialytic ambulatory BP was measured at the highest and lowest conductivities. BP, interdialytic weight gains and thirst scores were low at the outset and were not altered significantly by conductivity reduction. The lowest fixed dialysate setting of 13.2 mS/cm resulted in greater sodium depuration than the lowest conductivity setting allowable with DC, as reflected by lower post dialysis plasma conductivity (13.4 +/- 0.14 mS/cm versus 13.5 +/- 0.04 mS/cm, p < 0.001). Predialysis ECW fell from 0.22 +/- 0.04 l/kg to 0.21 +/- 0.09 l/kg as conductivity reduced with HD (p < 0.05), but did not change significantly with DC. When HD and DC were matched for end-dialysis plasma conductivity, there were no differences in BP, IDH frequency, or dialysis tolerability even at the lowest conductivity settings. In a setting of dialysate sodium reduction, DC did not appear to have any short-term clinical advantage over standard dialysis, and its range is limited at the lower conductivity settings. SN - 1538-943X UR - https://www.unboundmedicine.com/medline/citation/17413560/Comparison_of_progressive_conductivity_reduction_with_diacontrol_and_standard_dialysis_ L2 - https://doi.org/10.1097/01.mat.0000250787.65643.b8 DB - PRIME DP - Unbound Medicine ER -