The possibility of online HDF substitution fluid as the substitute for dialysate CHDF

Abstract

Due to the Tohoku earthquake and resulting tsunami, the supply of dialysate and substitution fluid used for continuous hemodiafiltration (CHDF) in our hospital has become unstable. Therefore, online HDF substitution fluid was used as the CHDF dialysate. We herein report on the investigation carried out in order to reconfirm safety. Dialysis patient monitoring equipment was used to collect dialysate in a bag for transfusion using a fluid replacement pump. The presence of ET, cultivation study, change in composition, and calcium carbonate deposition was confirmed. The pH value increased compared to when it was prepared, exceeding pH7.4 after approximately 18 hours. The PCO2 showed a tendency to decrease over time. Calcium carbonate was not observed upon visual inspection. ET/viable cells were not detected. In this study, it was suggested that online substitution fluid may be successfully used as the dialysate of CHDF.