PMID- 1457951
OWN - NLM
STAT- MEDLINE
DCOM- 19930111
LR  - 20190911
IS  - 1058-2916 (Print)
IS  - 1058-2916 (Linking)
VI  - 38
IP  - 3
DP  - 1992 Jul-Sep
TI  - Dialysate and blood flow dependence of diffusive solute clearance during CVVHD.
PG  - M691-6
AB  - To define the flow dependence of diffusive solute clearance (Kd) during 
      continuous venovenous hemodiafiltration (CVVHD), urea, creatinine, and phosphate 
      clearance were measured during CVVHD, while ultrafiltration was minimized. 
      Studies were performed using AN69, polyacrylonitrile (PAN), and polyamide (PA) 
      hollow fiber hemofilters. To assess the dialysate flow dependence of Kd, 
      clearances were measured at constant blood flow (QB), while dialysate inflow 
      (QDi) was increased incrementally from 8.3 to 33.3 ml/min. Kd increased linearly 
      for all three solutes using all membranes. To assess its blood flow dependence, 
      Kd was measured at blood flows of 50, 75, 100, and 150 ml/min, while QDi was held 
      constant at 33.3 ml/min. The PA membrane showed no flow dependence; for the other 
      membranes, Kd was flow independent for QB > 100 ml/min. At all values of QB and 
      QDi, clearances for the AN69 and PAN membranes were two to three times that of 
      the PA membrane (p < 0.01). Lactate uptake increased with increasing QDi for all 
      three membranes, but did not result in blood lactate accumulation. It is 
      concluded that: 1) small molecule clearance is dialysate flow limited during 
      CVVHD; 2) increasing QB beyond 100 ml/min is unnecessary for maintaining solute 
      clearance; and 3) the PA membrane is unsuitable for CVVHD because of its low 
      diffusive solute clearance.
FAU - Relton, S
AU  - Relton S
AD  - Department of Medicine, University of Pittsburgh School of Medicine, 
      Pennsylvania.
FAU - Greenberg, A
AU  - Greenberg A
FAU - Palevsky, P M
AU  - Palevsky PM
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
PL  - United States
TA  - ASAIO J
JT  - ASAIO journal (American Society for Artificial Internal Organs : 1992)
JID - 9204109
RN  - 0 (Dialysis Solutions)
RN  - 0 (Lactates)
RN  - 0 (Phosphates)
RN  - 33X04XA5AT (Lactic Acid)
RN  - 8W8T17847W (Urea)
RN  - AYI8EX34EU (Creatinine)
SB  - IM
MH  - Biological Transport, Active
MH  - Blood Flow Velocity
MH  - Creatinine/metabolism
MH  - Dialysis Solutions
MH  - Hemofiltration/*methods
MH  - Humans
MH  - Kidney Failure, Chronic/metabolism/therapy
MH  - Kinetics
MH  - Lactates/metabolism
MH  - Lactic Acid
MH  - Phosphates/metabolism
MH  - Urea/metabolism
EDAT- 1992/07/01 00:00
MHDA- 1992/07/01 00:01
CRDT- 1992/07/01 00:00
PHST- 1992/07/01 00:00 [pubmed]
PHST- 1992/07/01 00:01 [medline]
PHST- 1992/07/01 00:00 [entrez]
AID - 10.1097/00002480-199207000-00127 [doi]
PST - ppublish
SO  - ASAIO J. 1992 Jul-Sep;38(3):M691-6. doi: 10.1097/00002480-199207000-00127.