SP474OF INFORMATION TECHNOLOGY FOR REAL-TIME TREATMENT MONITORING WITHIN A HEMODIALYSIS UNIT: WHAT IS THE ACTUAL DELIVERED DOSE?OF INFORMATION TECHNOLOGY FOR REAL-TIME TREATMENT MONITORING WITHIN A HEMODIALYSIS UNIT: WHAT IS THE ACTUAL DELIVERED DOSE?

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INTRODUCTION AND AIMS: The prescribed hemodialysis dose may differ from the treatment that patients actually receive. Real-time integration of information technology systems with hemodialysis machines can help optimise the delivered treatment, and therefore, patient morbidity and mortality. METHODS: We retrospectively analyzed data from 9522 hemodialysis sessions, which corresponded to 85 patients in our Unit along a whole year in 2015. We excluded transitory patients and those who did not have a constant dialysis schema. We used FMC-5008 dialysis machines, connected real-time to Therapy Monitor interface and TSS (FMC). We analyzed the demographics of the patients (age, CKD etiology, comorbidities), prescribed dialysis treatment, actual delivered dose and intradialysis parameters (vascular access and its pressures, arterial pressure, machine alarms and hypotensive events, KT, Kt/V and convection exchange volume). RESULTS: Each patient received a median of 143 dialysis sessions [32-192], lasting 3h46min [3:30-4:30]. We observed that the median deviation between the prescription time and the actual delivered time was a median of 9.01 minutes [1.1-28 min]. For a 15.5% of the patients this time meant a reduction higher than 10 minutes out of their total dialysis time in at least 20 % of the yearly sessions. Most frequently, this was associated with having central venous catheter as vascular Access, age and a higher Charlson comorbidity index. This implied a lack of consecution of the dose target for a 78,5 % of this subgroup of patients. (RR 1,98 p<0,05). CONCLUSIONS: The actual dialysis dose our patients receive is lower than the prescribed. In our experience, patients with CVC, older and with a higher comorbidities may be in a higher risk for achieving the adequate dose. Information technologies coupled real time to the conventional dialysis machines can help detecting this mismatches, and therefore enable doctors to implement measures to correct them, before the monthly review.

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