Abstract
The continuous measurement of hematocrit value using CLIT-LINE has been reported to be useful stabilizing the clinical symptoms during hemodialysis, and in controlling dry-weight in patients with ESRD. In addition, CLIT-LINE is theoretically available to catch the information of sequential change of the fluid transfer between inter-cellular and extra-cellular space. In this study, we evaluated the accuracy of hematocrit value measured by CLIT-LINE, monitored continuous plasma refilling rate (PRR) during hemodialysis, and subsquently evaluated the efficacy of an original ultrafiltration system synchronized with the change in hematocrit value in 50 patients with ESRD. Their primary disease were CGN (27), DM (10), NS (5), SLE (4), PKD (3), and unknown (1).In vitro, we compared hematocrit values as measured by CLIT-LINE with those of conventional measurements under as different temperature conditions (26, 36, and 46°C) or blood flow rates (100 or 200ml/min) using blood samples from healthy subjects. In addision, we continuously monitored the PRR using our originally developed system connected with single patient dialysis machine (SDS-30) to CLIT-LINE, and evaluated whether PRR is correlated with the change in total blood volume. Total blood volume was then hypothesized to be 8%. ratio by body weight in vivo. Both blood temperature and blood flow affected the hematocrit values measured by CLIT-LINE. The PRR determined by CLIT-LINE correlated well with the changes in total blood volume induced by the ultrafiltration. Furthermore, our ultrafiltration system synchronized with hematocrit value was effective in preventing the hypotension following the removal of target fluid during hemodialysis in 80%. of the patients, but was not-effective in 20% of the patients, especially in patients with ischellLic heart disease. In conclusion, our ultrafiltration system sequentially synchronized with changes in hematocrit value using CLIT-LINE is effective in stabilizing clinical symptoms during hemodialysis in patients with ischemic heart disease.
