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Related Experiment Videos

Assessing the adequacy of dialysis

P E Teschan, H E Ginn, J R Bourne

    Proceedings of the European Dialysis and Transplant Association. European Dialysis and Transplant Association
    |January 1, 1981
    PubMed
    Summary

    Reducing dialysis time in chronic renal failure patients worsened objective brain function measures, indicating that a minimum clearance level is crucial for adequate dialysis and preventing uremia.

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    Area of Science:

    • Nephrology
    • Neuroscience
    • Uremia Research

    Background:

    • Objective measures of brain function (EEG, cognitive tests) previously identified clinical differences in chronic renal failure patients.
    • These measures can objectively assess the neurobehavioral syndrome of clinical uremia.

    Purpose of the Study:

    • To determine if standard thrice-weekly dialysis time could be reduced in chronic renal failure patients without inducing clinical uremia.
    • To establish a minimum level of adequate dialysis using urea clearance parameters.

    Main Methods:

    • A prospective experiment involving 10 patients with chronic renal failure.
    • Three periods: 3-month control (C1), 6-month experimental (E) with reduced dialysis, and 3-6 month control (C2).
    • Measures included quantified electroencephalogram (EEG), choice reaction time (CRT), continuous memory test (CMT), and clinical-symptom/self-evaluation questionnaire (CSE).

    Main Results:

    • Reducing dialysis clearance to 50-80% of the control level (3000ml/wk/L) worsened all objective measures: EEG (54%), CRT (2.5%), CMT (21%), and CSE (11%).
    • Blood urea nitrogen (BUN) levels rose slightly, and urea generation rates fell.
    • Patients reported feeling better despite recording more severe symptoms on the CSE questionnaire.

    Conclusions:

    • A total renal (Kr) plus dialyzer (Kd) urea clearance of 3000ml/wk/L approximates a minimum level for adequate dialysis.
    • Objective neurobehavioral measures effectively detect inadequate dialysis and the onset of clinical uremia.

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