eco future using eco features in dialysis: water and dialysate saving without compromising kt/v...

ECO future using ECO features in dialysis: Water and dialysate saving without compromising Kt/V

Asuncion Martinez

Director, Nursing Care

Fresenius Medical Care - NephroCare Spain

Madrid, Spain

Malmö, 31 August 2013

1 Introduction

2 Objectives

Background3

Methods4

Outline

FME © Copyright - ECO future using ECO features in dialysis... EDTNA/ERCA, Malmö 31 August - 3 September 2013

Results5

Conclusions6

FME © Copyright - ECO future using ECO features in dialysis...

Introduction

• The current trend toward “greening” dialysis is clear.

• For dialysis providers “going green” requires more than just the desire to do the right thing.

• Being “green” requires the responsible use and management of natural resources.

EDTNA/ERCA, Malmö 31 August - 3 September 2013


Objectives

• The aim of this project is to provide adequate Kt/V for patients while reducing dialysate consumption, water, and energy during the treatment.



Background

• The dialysis dose delivered to a patient is influenced by a number of factors:

• Blood flow rate

• Treatment time

• Type of treatment

• Dialysis fluid flow rate (Qd)



Methods

• Prescriptions were changed from standard dialysate flowto AutoFlow

• The project was carried out between January and November 2012. The data used for the analysis were extracted from a clinical database.


• The following parameters were collected: • Effective blood flow rate• Mean dialysate flow rate• Effective dialysis treatment time• Kt/V via an online monitoring system• Water consumption per treatment


Results: Trends analysis


HighVolume HDF

Haemodialysis


Results: Correlation Kt/V vs AutoFlow


Number of XY Pairs 18431Pearson r -0,198695% confidence interval -0.2124 to -0.1847P value (two-tailed) P<0.0001P value summary ***Is the correlation significant? (alpha=0.05) Yes

Number of XY Pairs 4812Pearson r -0,235495% confidence interval -0.2619 to -0.2085P value (two-tailed) P<0.0001P value summary ***Is the correlation significant? (alpha=0.05) Yes


Results: Correlation Kt/V vs treatment time


Number of XY Pairs 4812Pearson r 0,109895% confidence interval 0.08182 to 0.1377P value (two-tailed) P<0.0001P value summary ***Is the correlation significant? (alpha=0.05) YesR squared 0,01206

Number of XY Pairs 18431Pearson r 0,00572095% confidence interval -0.008721 to 0.02016P value (two-tailed) 0,4374P value summary nsIs the correlation significant? (alpha=0.05) NoR squared 0,00003272


Results: Correlation Kt/V vs blood flow


Number of XY Pairs 4810Pearson r 0,457195% confidence interval 0.4344 to 0.4791P value (two-tailed) P<0.0001P value summary ***Is the correlation significant? (alpha=0.05) Yes

Number of XY Pairs 18426Pearson r 0,281995% confidence interval 0.2685 to 0.2951P value (two-tailed) P<0.0001P value summary ***Is the correlation significant? (alpha=0.05) YesR squared 0,07945


Conclusions (1)


• Technological improvements provide appropriate tools (e.g. AutoFlowTM, OCMTM, etc.) ensuring the achievement of objectives without increasing the costs of dialysis.


Conclusions (2)

• In our project, considerable savings in dialysate consumption were achieved by changing from a standard dialysate flow or AutoFlow 1.5 to AutoFlow ≤1.2, thus enhancing the effect of other components of a good dialysis treatment.

• An increase in the overall quality of haemodialysis therapy (including a reduction of the environmental impact) does not necessarily mean an increase in cost.


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Acknowledgments

Jose Ignacio Merello Country Medical DirectorFresenius Medical Care - NephroCare, Madrid, Spain

Rosa Ramos PhysicianFresenius Medical Care - NephroCare, Madrid, Spain

Francesco Pelliccia Nursing Care Coordinator Region Western EuropeFresenius Medical Care – NephroCare Coordination ,Palazzo Pignano, Italy

Maria Teresa Parisotto Director, Nursing Care ManagementFresenius Medical Care - NephroCare Coordination, Bad Homburg, Germany


eco future using eco features in dialysis: water and dialysate saving without compromising kt/v...

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