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NDT Advance Access originally published online on July 26, 2005
Nephrology Dialysis Transplantation 2005 20(11):2479-2484; doi:10.1093/ndt/gfi021
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© The Author [2005]. Published by Oxford University Press on behalf of ERA-EDTA. All rights reserved. For Permissions, please email: journals.permissions@oxfordjournals.org

Original Article

Assessing the utility of the stop dialysate flow method in patients receiving haemodiafiltration

J. P. Traynor1, H. A. Oun2, P. McKenzie3, I. R. Shilliday2, I. G. McKay3, A. Dunlop3, C. C. Geddes1 and R. A. Mactier4

1 Renal Unit, Western Infirmary, Glasgow, 2 Renal Unit, Monklands Hospital, Airdrie, 3 Renal Unit, Crosshouse Hospital, Kilmarnock, UK and 4 Renal Unit, Glasgow Royal Infirmary, Glasgow, UK

Correspondence and offprint requests to: J. P. Traynor, Renal Unit, Western Infirmary, Glasgow, UK. Email: jamie.traynor{at}northglasgow.scot.nhs.uk or jamie.traynor1{at}ntlworld.com

Background. The stop dialysate flow (SDF) method of post-dialysis urea sampling is the most commonly used method in the UK. It can also be used with a published formula to predict 30 min equilibrated urea accurately. The method has not been validated in patients undergoing haemodiafiltration (HDF). Given the increased use of HDF across Europe, we felt it prudent to assess the utility of the SDF method and prediction equation in this modality.

Methods. Fourteen patients from two renal units were studied. Blood samples were taken at 1 min intervals from the arterial side of the dialysis circuit in the first 5 min after HDF had ceased whilst blood circulation continued. A peripheral sample was taken from the contralateral arm immediately after HDF had ceased and a 30 min sample was taken from the arterial needle. These samples were used to assess the utility of 5 min arterial blood urea and the 30 min prediction formula, respectively.

Results. Blood urea measured from the arterial circuit at 5 min correlated closely with the contralateral sample taken immediately post-HDF, with no significant difference (6.45±2.11 vs 6.52±2.19 mmol/l, P = 0.39). The use of 5 min arterial blood urea and prediction formula allowed an accurate prediction of 30 min urea (R2 = 0.96).

Conclusions. The use of the SDF method with a 5 min post-HDF arterial sample is valid in patients receiving HDF. The previously published prediction formula for estimating 30 min urea is also valid using the 5 min post-HDF sample.

Keywords: haemodiafiltration; Kt/V; post-dialysis urea rebound; stop dialysate flow; urea reduction ratio


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