Application of therapeutic ultrasonic waves across the dialyzer membrane: A pilot study on the impact on dialyzer clearance and safety

IF 1.2 4区医学 Q3 UROLOGY & NEPHROLOGY Hemodialysis International Pub Date : 2024-05-24 DOI:10.1111/hdi.13161

Girish Namagondlu Seetharamaiah, Limesh Marisiddappa, Shashank Dhareshwar, Savitha Rani, Nikhil Das

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Abstract

Introduction

Progressive clogging of the dialyzer membrane during hemodialysis can compromise solute removal efficiency. Existing solutions fall short in addressing intradialytic reduction of dialyzer clearance. This pilot study aims to assess the impact and safety of applying therapeutic ultrasonic waves to dialyzers for mitigating intradialytic clogging.

Methods

In this pilot study, 15 stable maintenance hemodialysis patients (12 males and 3 females) were enrolled. Each patient served as their own control. They underwent one session of hemodialysis with the application of therapeutic ultrasonic waves (Ultrasonic session) and were crossed-over to a second session without the use of ultrasonic waves (Control session). All the study sessions operated at a fixed dialysate flow rate of 500 mL/min and a blood flow rate of 250 or 300 mL/min. The adequacy of dialysis achieved during each session was monitored using Online Clearance Monitoring of the dialysis machines, and clearance K values, varying between 135 and 209 mL/min, were recorded, and plotted. A direct comparison between Control and Ultrasonic sessions was performed to assess the impact and safety of using ultrasonic waves during hemodialysis.

Findings

The mean percentage decline in dialyzer clearance values was 4.41% for Ultrasonic sessions (SD: 5.3) and 12.69% for Control sessions (SD: 6.35) (p-value <0.001). This indicates that the application of ultrasonic waves reduced the decline in clearance values. The mean differences of the blood component parameters were comparable between both Ultrasonic sessions and Control sessions, suggesting the safety of utilizing ultrasonic waves during dialysis. Microscopic membrane analysis corroborated the safety.

Discussion

Intradialytic clogging of dialyzer membranes is a significant problem that can cause dialysis inadequacy. Our study tackles this issue by introducing therapeutic ultrasonic waves to improve dialyzer clearance during hemodialysis sessions in patients.

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在透析器膜上应用治疗性超声波：关于透析器清除率和安全性影响的试点研究。

简介血液透析过程中透析器膜的逐渐堵塞会影响溶质清除效率。现有的解决方案无法解决透析器内清除率降低的问题。本试验研究旨在评估在透析器上应用治疗性超声波以减轻透析器内堵塞的影响和安全性：在这项试验性研究中，共招募了 15 名稳定的维持性血液透析患者（12 名男性和 3 名女性）。每位患者都是自己的对照组。他们接受了一次应用治疗性超声波的血液透析治疗（超声波治疗），并交叉接受了第二次不使用超声波的血液透析治疗（对照治疗）。所有研究时段的透析液流速固定为 500 毫升/分钟，血流量为 250 或 300 毫升/分钟。利用透析机的在线清除率监测系统对每次透析过程中的透析充分性进行监测，记录并绘制清除率 K 值（介于 135 至 209 毫升/分钟之间）。对对照组和超声波组进行直接比较，以评估在血液透析过程中使用超声波的影响和安全性：结果：超声波透析的透析器清除率平均下降了 4.41%（SD：5.3），而对照组下降了 12.69%（SD：6.35）（P 值讨论）：透析膜的椎管内堵塞是导致透析不足的一个重要问题。我们的研究通过引入治疗性超声波来改善患者血液透析过程中透析器的清除率，从而解决了这一问题。

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来源期刊

Hemodialysis International UROLOGY & NEPHROLOGY-

CiteScore

2.50

自引率

0.00%

发文量

审稿时长

6-12 weeks

期刊介绍： Hemodialysis International was originally an annual publication containing the Proceedings of the International Symposium on Hemodialysis held in conjunction with the Annual Dialysis Conference. Since 2003, Hemodialysis International is published quarterly and contains original papers on clinical and experimental topics related to dialysis in addition to the Annual Dialysis Conference supplement. This journal is a must-have for nephrologists, nurses, and technicians worldwide. Quarterly issues of Hemodialysis International are included with your membership to the International Society for Hemodialysis. The journal contains original articles, review articles, and commentary to keep readers completely updated in the field of hemodialysis. Edited by international and multidisciplinary experts, Hemodialysis International disseminates critical information in the field.