Effect of venovenous extracorporeal ultrafiltration method (VVECUM)

Abstract

We retrospectively analyzed the effect of extracorporeal ultrafiltration method via peripheral veins (venovenous ECUM) in peritoneal dialysis (PD) patients with excessive body fluid retention. Since 2004, a total of 4 PD patients (1 male and 3 female) were treated with VVECUM. Two veins either at the forearm or upper arm were punctured by 16 G needles and the blood flow was kept at 60-100 mL/min. Heparin was used as an anticoagulant in all cases and the treatment time was around 2 hours per day. Based on the hydration status, the number of individual treatments was adjusted. Although residual renal function (RRF) was relatively low in all cases, PD therapy was possible for a limited (4 to 6 months) period after normalization of body fluid by VVECUM. Furthermore, long-term (over 42 months) PD therapy was successfully continued in a case that showed sufficient ultrafiltration volume and good control of fluid intake. Without this VVECUM treatment, all cases would have been immediately transferred to standard hemodialysis or required complementary hemodialysis due to refractory fluid retention. These findings suggest that VVECUM treatment made the patients more aware of hemodialysis and motivated them to continue PD, which was the patient's own choice, and to maintain strict restriction in fluid intake.