Nephrology Dialysis Transplantation, Vol 13, Issue 12 3118-3125, Copyright © 1998 by Oxford University Press
W Kleophas, B Haatert, G Backus, P Hilgers, A Westhoff and G van Endert
Background. This paper discusses long-term experience
with a specific type of dialysis equipment which has been used more than 15
years without variation. The system was designed to allow easy
individualization of dialysis fluid composition and to deliver dialysate of
the highest hygienic quality. Methods. Data from 399
patients covering the period from 1971 onwards were analysed
retrospectively. Survival probabilities were estimated by the Kaplan-Meier
method and the median number of days in hospital was calculated. Additional
data collected from patient subgroups included serum albumin level,
erythropoietin requirement and antihypertensive treatments. Kt/V and PCR
from one subgroup were computed using the formulae of Daugirdas and Depner.
Results. The estimated survival probability after 5
years for all patients was 59.1% (95% CI:52.6-65.6%). The main risk factors
from the available covariables were age and IDDM. The cumulative incidence
of carpal tunnel syndrome after 10 years of dialysis was estimated as 7%
(95% CI: 0-14%). Data from the subgroups revealed that 82% of the patients
had serum albumin levels >4.0 g/dl, 65% of the patients received no
antihypertensive drugs and 39% received erythropoietin (37±28
units/kg bw/week) to correct dialysis anaemia (haemoglobin
level=98±8 g/l). Average Kt/V was 1.21±0.17, PCR was
1.10±0.22 g/kg/day. Conclusions. The setup
described permits individualized therapy of high quality. The high serum
albumin values and our very low incidence of carpal tunnel syndrome
underline the importance of water and dialysate quality.
Keywords: batch type dialysis machine; hemodialysis;
hygienic; individualized dialysis fluid; quality of treatment; survival
ORIGINAL ARTICLES
Long-term experience with an ultrapure individual dialysis fluid with a batch type machine
Dialysezentrum Karlstrasse, Karlstrasse 17-19, D-40210 Dusseldorf, Germany; Diabetes Forschungsinstitut an der Heinrich-Heine-Universitat, Abteilung Biometrie und Epidemiologie, Dusseldorf, Germany; Fresenius Medical Care GmbH, Bad Homburg, Germany
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