Abstract
[Aim] Althought the plasma refilling rate (PRR) during a hemodialysis (HD) session can be estimated by the CRIT-LINETM monitor (CLM), the optimal methods for measuring the PRR has not been established. Then, we investigate 11 methods for measuring the PRR to find an adequate and useful method. [Patients and Methods] Patients with stable blood pressure during HD participated in this study. Eleven methods of measuring the PRR using a combination of three patterns (UF-A, -B and -C) of ultrafiltration profile and a biometry method (8% method) and four kinds of recursion methods (Hct I method, ΔBV% I method, Hct II method and ΔBV% II method) for the effective blood volume (BV(0)) at the start of an HD session were investigated. [Results] The PRR values were reflected in the three different ultrafiltration profiles. The PRR value obtained using the 8%-A method was 8.7±1.6mL/min. There was no significant difference between the PRR value obtained using the 8%-A method and that obtained using various BV(0) methods and the UF-C method. The PRR values measured using UF-B method were significantly lower than those measured using UF-A, or -C method (p<0.01, n=13). [Discussion] The PRR value obtained using the UF-A method is the value on ultrafiltration, while the PRR value obtained using the UF-B method is thought to be the physiological PRR. The UF-C method may be useful to determine the relationship between the colloid osmotic pressure and the PRR. The biometry method for obtaining the BV(0) showed an advantage for measuring the PRR throughout the HD session. [Conclusion] The 8%-A method is the best method for measuring PRR on ultrafiltration, and the 8%-B method is useful for measuring the PRR in the absence of ultrafiltration.
