• Biomedical Science Letters
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• v.25 no.1
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• pp.32-39
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• 2019

Conventional high-flux hemodialysis (HD) is not as good as normal kidney function. Morbidity and mortality rates of patients receiving HD are still very high. To increase mid-to-large molecule clearance by combining diffusion and convection, on-line hemodiafiltration (HDF) is required. The objective of this study was to compare long-term survival rate of patients treated with on-line HDF to those who received conventional high-flux HD by reviewing data from Chonnam National University Hospital (CNUH). We selected patients who attended the 'CUNH dialysis center' and agreed to participate in the study. Overall, 40 patients with ESRD switched from high flux HD to on-line HDF or started on-line HDF from August 2007 to December 2009. Additionally, a total of 42 patients receiving conventional high-flux HD during the same period were enrolled. We then reviewed long-term survival rate of patients receiving on-line HDF over the next seven years. When we compared survival rates for seven years, the survival rate of the group receiving on-line HDF was 65% (26/40) while that of the group receiving the conventional high-flux HD was 54.8% (23/42). Although the number of patients was small to see survival difference clearly by one specific dialysis modality, there was somewhat difference in survival rate between the two groups. Indicators such as anemia, calcium-phosphate metabolism, nutritional status, treatment adequacy, and hospitalization were also improved in the group receiving HDF. Overall, results of our study showed beneficial effects of on-line HDF on clinical outcomes and survival in chronic HD patients.

• Journal of Biomedical Engineering Research
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• v.29 no.5
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• pp.376-383
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• 2008

High-flux dialysis treatment removes various toxins via diffusion as well as convection, which is induced by ultrafiltration and backfiltration. In this study, in vitro (Using the distilled water and the bovine's blood) comparison test was performed to determine whether utilization of a high flux dialyzer paired with different pumps would increase the efficiency of convection. At the same blood flow rates, a pulsatile pump and a roller pump were employed to propel the distilled water and bovine whole blood to a high flux dialyzer. Pressures at the dialyzer inlet and outlet in the blood circuit and in the dialysate circuit were measured, respectively. From these data, we calculated the transmembrane pressure and predicted the ultrafiltration and backfiltration rates developed by both pumps. Using the bovine's blood experiment, ultrafiltration and backfiltration rates were 1.6 times higher with the pulsatile pump than with the roller pump. We conclude that utilization of a pulsatile pump in high flux hemodialysis treatments increases ultrafiltration volume, compared with a roller pump under conditions of the same blood flow rate.

• Proceedings of the KSME Conference
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• 2008.11a
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• pp.1655-1659
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• 2008

Using numerical models, we investigated the efficiency of toxin removal using pulsatile flow in blood purification systems that use semipermeable membranes. The model consisted of a three-compartmental mass transfer model for the inside body and a solute kinetics model for the dialyzer. The model predicted the toxin concentration inside the body during blood purification therapy, and the toxin removal efficiencies at different flow configurations were compared quantitatively. According to the simulation results, the clearances of urea and ${\beta}_2$ microglobulin (B2M) using a pulsatile pump were improved by up to 30.9% for hemofiltration, with a 2.0% higher urea clearance and 4.6% higher B2M clearance for high flux dialysis, and a 3.9% higher urea clearance and 8.2% higher B2M clearance for hemodiafiltration. These results suggest that using a pulsatile blood pump in blood purification systems with a semipermeable membrane improves the efficacy of toxin removal, especially for large molecules and hemofiltration treatment.

• Journal of Korean Academy of Nursing Administration
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• v.13 no.4
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• pp.462-472
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• 2007

Purpose: Purpose of the this study is to define the hemodialysis noncompliance Indicators and discriminant standards levels for low Flux Hemodialysis patients and development of Hemodialysis noncompliance measurement - brief form. Method: Data was collected from 269 hemodialysis patients. To establish the hemodialysis noncompliance Indicators and to discriminate standards, 13 hemodialysis nurses and 2 nephrology doctors are participated in professional group. To verify the indicators and discriminant standards, data was ananlyzed by the canonical discriminant analysis method using by SAS 8.3 program. Result: 4 Indicators- interdialysis weight gain(IWG); average of recent 4weeks, serum phophate level, skipping of hemodialysis and hemodialysis time shortening without permission- of hemodialysis noncompliance are established and discriminant standards are developed. Discriminant ability of these 4 noncompliance indicators is 99.7%(p=.000). Hemodialysis noncompliance measurement - brief form has 96.3% discriminant accuracy. Conclusion: Hemodialysis noncompliant patients have high risks. It means that special intervention to noncompliance is needed. Also continuous and objective assessment and standards of noncompliance are needed.