OPTIMIZATION OF SODIUM-BALANCE DURING HEMODIALYSIS BY ROUTINE IMPLEMENTATION OF KINETIC MODELING - TECHNICAL ASPECTS AND PRELIMINARY CLINICAL-STUDY

A new biofeedback module (BM) is designed for optimization of dialysate conductivity during hemodialysis sessions. Based on information on treatment time, body weight, desired weight loss of the patient, and on measurements of the effective conductivity of the patient automatically performed by the BM without necessity of blood sampling, the conductivity of the dialysate is fully controlled during the dialysis session without any intervention of the staff. 133 dialysis sessions using the BM have been performed with a bicarbonate dialysate. There was a negative correlation (r = -0.8; p < 0.001) between the mean dialysate conductivity prescribed by the BM during the session and the predialytic plasma sodium level. Despite a great variability of the predialytic plasma sodium concentration, the postdialytic plasma sodium concentration was always close to 140 mmol/l. Thus, the BM allows routine implementation of kinetic modeling for automatic determination of dialysate conductivity by adjusting it to the predialytic plasma sodium concentration.