Practical utility of on-line clearance and blood temperature monitors as noninvasive techniques to measure hemodialysis blood access flow

• Published in: Blood purification Vol. 31; no. 1-3; p. 1
• Main Authors: Fontseré, Néstor, Blasco, Miquel, Maduell, Francisco, Vera, Manel, Arias-Guillen, Marta, Herranz, Sandra, Blanco, Teresa, Barrufet, Marta, Burrel, Marta, Montaña, Javier, Real, Maria Isabel, Mestres, Gaspar, Riambau, Vicenç, Campistol, Josep M
• Format: Journal Article
• Language: English
• Published: Switzerland 01-01-2011
• Subjects: Adult; Aged; Aged, 80 and over; Body Temperature; Female; Humans; Male; Middle Aged; Regional Blood Flow; Renal Dialysis - instrumentation; Renal Dialysis - methods; Renal Dialysis - standards
• ISSN: 1421-9735
• DOI: 10.1159/000321364

Access blood flow (Qa) measurements are recommended by the current guidelines as one of the most important components in vascular access maintenance programs. This study evaluates the efficiency of Qa measurement with on-line conductivity (OLC-Qa) and blood temperature monitoring (BTM-Qa) in comparison with the gold standard saline dilution method (SDM-Qa).
50 long-term hemodialysis patients (42 arteriovenous fistulas/8 arteriovenous grafts) were studied. Bland-Altman and Lin's coefficient (ρ(c)) were used to study accuracy and precision.
Mean values were 1,021.7 ± 502.4 ml/min SDM-Qa, 832.8 ± 574.3 ml/min OLC-Qa (p = 0.007) and 1,094.9 ± 491.9 ml/min with BTM-Qa (p = NS). Biases and ρ(c) obtained were -188.8 ml/min (ρ(c) 0.58) OLC-Qa and 73.2 ml/min (ρ(c) 0.89) BTM-Qa. The limits of agreement (bias ± 1.96 SD) obtained were from -1,119 to 741.3 ml/min (OLC-Qa) and -350.6 to 497.2 ml/min (BTM-Qa).
BTM-Qa and OLC-Qa are valid noninvasive and practical methods to estimate Qa, although BTM-Qa was more accurate and had better concordance than OLC-Qa compared with SDM-Qa.