SP622ONLINE CLEARANCE AND THEIR RELATION WITH THE VASCULAR ACCESS ANATOMY AND THE PUNCTURES CHARACTERISTICS

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Introduction and Aims: Achieving a KtV target is essential to ensure an adequate quality of life and prevent complications in hemodialysis (HD) patients. The clearance of a substance is defined by the dialyzer characteristics, the dialysate flow (QD) and the proper operation of the vascular access (VA). The key is to get a good blood flow (QB) with the less recirculation percentage possible. The objective of this work is to define the ranges of the online clearance values (OCMc) measured by the Fresenius on line clearance monitor depending on the VA anatomy and different QB. These new ranges values, could detect early dysfunction of this VA and prevent possible complications. Methods: We analyzed 40 HD patients, stables for 3 months. We monitor in each patient the OCMc at different QB (300, 400, 500 mL/min) during two sessions using the same dialyzer and QD (500 ml/min). We also measured the average of these OCM parameters and their effective QB (Qef) associated, obtained in the Fresenius 4008 Monitor. We studied epidemiologic data and defined the different ratio OCMc/ Qef considering: 1. Native fistulae (AVF) vs grafts. 2. Proximal or distal arterio-venous anastomosis (elbow vs wrist). 3. Puncture in the same or different veins. 4. The influence of the punctures distances (D).

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