Evaluation of Different Dialyzers and the Impact of Predialysis Albumin Priming in Intermittent Hemodialysis With Reduced Anticoagulation
Introduction: Systemic anticoagulation is widely used in routine clinical hemodialysis, but can be contraindicated in specific settings. Anticoagulant-free treatment regimens are prone to failure even in chronic intermittent hemodialysis. We quantified fiber blocking in settings of reduced anticoagu...
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doaj-26209a1b470c4e18baf6b3f641ffd8212020-11-25T01:32:47ZengElsevierKidney International Reports2468-02492019-11-0141115381545Evaluation of Different Dialyzers and the Impact of Predialysis Albumin Priming in Intermittent Hemodialysis With Reduced AnticoagulationFloris Vanommeslaeghe0Filip De Somer1Iván Josipovic2Matthieu Boone3Wim Van Biesen4Sunny Eloot5Department of Nephrology, Ghent University Hospital, Gent, BelgiumDepartment of Cardiac Surgery, Ghent University Hospital, Gent, BelgiumCentre for X-ray Tomography, Physics and Astronomy, Ghent University, BelgiumCentre for X-ray Tomography, Physics and Astronomy, Ghent University, BelgiumDepartment of Nephrology, Ghent University Hospital, Gent, BelgiumDepartment of Nephrology, Ghent University Hospital, Gent, Belgium; Correspondence: Sunny Eloot, Hemodialysis Unit 1P8, Ghent University Hospital, Corneel Heymanslaan 10, 9000 Gent, Belgium.Introduction: Systemic anticoagulation is widely used in routine clinical hemodialysis, but can be contraindicated in specific settings. Anticoagulant-free treatment regimens are prone to failure even in chronic intermittent hemodialysis. We quantified fiber blocking in settings of reduced anticoagulation to assess performance of different dialyzers and the potential benefit of albumin priming. Methods: This crossover study included 10 patients performing 4 hours of hemodialysis at midweek in 7 different settings: that is, using Solacea 19H and FX800, both with regular and half dose of anticoagulation, Evodial 1.3 without systemic anticoagulation, and FX800 (half dose) and Evodial (no anticoagulation) when primed with a human albumin solution. Dialyzer fiber blocking was visualized in the dialyzer outlet potting using a 3-dimensional computed tomography (CT) scanning technique on micrometer resolution. Results: No sessions had to be prematurely interrupted because of circuit clotting. The relative number of open fibers post dialysis was not influenced by the reduction of anticoagulation in the Solacea making this dialyzer superior in fiber patency in this setting above both the FX800 with reduced anticoagulation and the Evodial with no anticoagulation. Furthermore, no differences in relative number of open fibers were found in the FX800 and Evodial dialyzers with versus without albumin priming. Conclusion: In situations in which reduced anticoagulation is indicated, the asymmetric triacetate ATA Solacea dialyzer outperforms a dialyzer with a conventional polysulfone membrane (FX800) or with the heparin-coated polyacrylonitrile membrane (Evodial). The use of human albumin to prime the dialysis circuit did not improve dialyzer patency. Keywords: albumin priming, clotting, coagulation, dialyzer, fiber patency, zero anticoagulationhttp://www.sciencedirect.com/science/article/pii/S2468024919314275 |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Floris Vanommeslaeghe Filip De Somer Iván Josipovic Matthieu Boone Wim Van Biesen Sunny Eloot |
spellingShingle |
Floris Vanommeslaeghe Filip De Somer Iván Josipovic Matthieu Boone Wim Van Biesen Sunny Eloot Evaluation of Different Dialyzers and the Impact of Predialysis Albumin Priming in Intermittent Hemodialysis With Reduced Anticoagulation Kidney International Reports |
author_facet |
Floris Vanommeslaeghe Filip De Somer Iván Josipovic Matthieu Boone Wim Van Biesen Sunny Eloot |
author_sort |
Floris Vanommeslaeghe |
title |
Evaluation of Different Dialyzers and the Impact of Predialysis Albumin Priming in Intermittent Hemodialysis With Reduced Anticoagulation |
title_short |
Evaluation of Different Dialyzers and the Impact of Predialysis Albumin Priming in Intermittent Hemodialysis With Reduced Anticoagulation |
title_full |
Evaluation of Different Dialyzers and the Impact of Predialysis Albumin Priming in Intermittent Hemodialysis With Reduced Anticoagulation |
title_fullStr |
Evaluation of Different Dialyzers and the Impact of Predialysis Albumin Priming in Intermittent Hemodialysis With Reduced Anticoagulation |
title_full_unstemmed |
Evaluation of Different Dialyzers and the Impact of Predialysis Albumin Priming in Intermittent Hemodialysis With Reduced Anticoagulation |
title_sort |
evaluation of different dialyzers and the impact of predialysis albumin priming in intermittent hemodialysis with reduced anticoagulation |
publisher |
Elsevier |
series |
Kidney International Reports |
issn |
2468-0249 |
publishDate |
2019-11-01 |
description |
Introduction: Systemic anticoagulation is widely used in routine clinical hemodialysis, but can be contraindicated in specific settings. Anticoagulant-free treatment regimens are prone to failure even in chronic intermittent hemodialysis. We quantified fiber blocking in settings of reduced anticoagulation to assess performance of different dialyzers and the potential benefit of albumin priming. Methods: This crossover study included 10 patients performing 4 hours of hemodialysis at midweek in 7 different settings: that is, using Solacea 19H and FX800, both with regular and half dose of anticoagulation, Evodial 1.3 without systemic anticoagulation, and FX800 (half dose) and Evodial (no anticoagulation) when primed with a human albumin solution. Dialyzer fiber blocking was visualized in the dialyzer outlet potting using a 3-dimensional computed tomography (CT) scanning technique on micrometer resolution. Results: No sessions had to be prematurely interrupted because of circuit clotting. The relative number of open fibers post dialysis was not influenced by the reduction of anticoagulation in the Solacea making this dialyzer superior in fiber patency in this setting above both the FX800 with reduced anticoagulation and the Evodial with no anticoagulation. Furthermore, no differences in relative number of open fibers were found in the FX800 and Evodial dialyzers with versus without albumin priming. Conclusion: In situations in which reduced anticoagulation is indicated, the asymmetric triacetate ATA Solacea dialyzer outperforms a dialyzer with a conventional polysulfone membrane (FX800) or with the heparin-coated polyacrylonitrile membrane (Evodial). The use of human albumin to prime the dialysis circuit did not improve dialyzer patency. Keywords: albumin priming, clotting, coagulation, dialyzer, fiber patency, zero anticoagulation |
url |
http://www.sciencedirect.com/science/article/pii/S2468024919314275 |
work_keys_str_mv |
AT florisvanommeslaeghe evaluationofdifferentdialyzersandtheimpactofpredialysisalbuminpriminginintermittenthemodialysiswithreducedanticoagulation AT filipdesomer evaluationofdifferentdialyzersandtheimpactofpredialysisalbuminpriminginintermittenthemodialysiswithreducedanticoagulation AT ivanjosipovic evaluationofdifferentdialyzersandtheimpactofpredialysisalbuminpriminginintermittenthemodialysiswithreducedanticoagulation AT matthieuboone evaluationofdifferentdialyzersandtheimpactofpredialysisalbuminpriminginintermittenthemodialysiswithreducedanticoagulation AT wimvanbiesen evaluationofdifferentdialyzersandtheimpactofpredialysisalbuminpriminginintermittenthemodialysiswithreducedanticoagulation AT sunnyeloot evaluationofdifferentdialyzersandtheimpactofpredialysisalbuminpriminginintermittenthemodialysiswithreducedanticoagulation |
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