TO004
TREATMENT RELATED PREDICTORS AND RELATION TO SUBSTITUTION VOLUME AND DIALYSIS DOSE ON PATIENTS UNDER ONLINE HAEMODIFILTRATION

INTRODUCTION AND AIMS: Convective therapies are increasingly used in patients with ESKD, augmenting middle molecular weight uremic toxins clearance, such as β2 microglobulin, thus possibly improving patient outcomes. Combining diffusive and convective transport, Haemodiafiltration (HDF) apparently significant decreases mortality risk in patients with high Substitution volume (SV). Also, an adequate dialysis dose is one of the most import targets and should be ensured that patients receive the optimal treatment. Nonetheless, literature showed that treatment related factors, such as fixed treatment time (TT) and blood flow rates (Qb), rather than patient characteristics seems to have more influence on the magnitude of the convection volume.• To determine which factors explain the variation of spKt/V and SV in patients undergoing Online HDF (OL HDF).

METHODS: It’s a descriptive-correlational, multicentre, observational study involving active patients on OL post-dilution HDF. Data were collected for one month (April 2016) of follow-up. Only patients with internal vascular access were eligible. All dialysis machines used and dialysers, including areas were similar. Demographics data, various clinical treatment and laboratory parameters were collected.The backward elimination approach was used to select the best set of independent variables. The factors that contributed significantly on influencing spKt/V and SV, were identified by regression analysis. Results were considered statistically significant (SS) when p<0.05.

RESULTS: 2,829 patients were enrolled, the baseline characteristics were, age 68.96 SD=13.75 years, 60.8% were male. The average dry weight was 68.55 kg, UF removed (UFr) 2.56 L, Qb 427.13 mL/min, TT 241.55 min, heparin dose was 58.15 UI/Kg, Haematocrit (Hct) (vol%) 33.92, Overhydration (OH) status 1.53L. The results for the dependents variables were SV 24.14 SD=2.60L and spKt/V 2.05 SD=0.38.We found a positive correlation r=0.688 and r=0.664 between factors for spKt/V and SV respectively. The multivariable regression analyses model was SS [F (7, 2767) = 355.300, p<0.001] and explains 47.2% of the variation in spKt/V. Similar results were obtained for the SV.The model showed that Qb, OH status and TT had a positive effect (SS) on spKt/V and SV (Table 1 and 2). On the other hand, dry weight (DW), UFr, Hct and anticoagulation had a negative effect (SS).

TO004 Figure 1

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TO004 Figure 2

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CONCLUSIONS: The factors with larger dimension of its negative effect on the dependent variables were DW (29.93%) and UFr (18.19%). Oppositely it was concluded that the Qb was the factor with the greatest positive effect (28.13%).Anticoagulant dose doesn’t significantly explain spKt/V but is important for SV, probably by counteracting the propensity for intra-dialyser clotting.