Hemodialysis efficiency management from the viewpoint of blood removal pressure

Ther Apher Dial. 2021 Apr;25(2):152-159. doi: 10.1111/1744-9987.13557. Epub 2020 Sep 21.

Abstract

Degradation of dialysis efficiency during hemodialysis, caused by incompatible indwelling needle size or increase in hematocrit, is a serious problem that can threaten a patient's life. This study aims to derive a quantitative index for determining the indwelling needle diameter that can maintain an appropriate blood flow rate, and presents an effective method to prevent a decrease in the actual blood flow rate. The relationships between the set flow rate and various parameters such as indwelling needle diameter, blood viscosity, and arterial line pressure are analyzed. A simple and reliable method for estimating the actual blood flow rate is derived from these relationships. A correlation between viscosity and actual blood flow rate is estimated adequately by regression analysis using a least-squares method. The relationship between Reynolds number and the flow rate reduction ratio is also evaluated. A new parameter (simple estimation method for actual blood flow) is derived by measuring the blood removal pressure. A pump control approach that uses blood removal pressure is suggested, which can be a future research direction in the field of hemodialysis.

Keywords: blood removal pressure; blood viscosity; dialysis efficiency; dialysis indwelling needle; flow rate reduction ratio; hemodialysis; transition level; turbulence.

MeSH terms

  • Blood Flow Velocity / physiology*
  • Blood Pressure
  • Blood Viscosity / physiology*
  • Equipment Design
  • Hematocrit
  • Humans
  • Needles*
  • Regression Analysis
  • Renal Dialysis / instrumentation
  • Renal Dialysis / methods*
  • Reproducibility of Results