The Effect of Increasing Needle Size on Dialysis Adequacy in Hemodialysis Patients / 대한신장학회잡지

ABSTRACT

BACKGROUND: Kt/V is an important index of adequacy of dialysis in patients undergoing hemodialysis (HD). However, it is difficult to prolong dialysis time in practice because of its economic impact and poor patient compliance. This study was performed to investigate the effect of increasing dialysis needle size on dialysis adequacy in HD patients. METHODS: This study enrolled 70 patients who received HD thrice weekly for more than 3 months using arteriovenous fistula or graft. The patients were divided into three groups according to the blood flow rate (200, 250, 300 mL/min). We first performed HD using 16 gauge needle. And then we increased needle size up to 15 gauge without change of any other dialysis conditions such as blood and dialysate flow rates, dialysis time, distance between needle insertion sites. RESULTS: Mean Kt/V at HD method using 15 gauge needle was increased, compared with HD method using 16 gauge needle (1.31+/-0.18 vs. 1.23+/-0.18, p<0.001). When comparing Kt/V according to the blood flow rate, increasing needle size from 16 gauge to 15 gauge significantly increased Kt/V at 250 mL/min and 300 mL/min. But there was no difference in Kt/V at 200 mL/min of blood flow rate. VDP at HD method using 15 gauge needle was decreased, compared with HD method using 16 gauge needle (88+/-23 mmHg vs. 118+/-28 mmHg, p<0.001). CONCLUSION: This study suggests that increasing dialysis needle size is safe and effective method in improving dialysis adequacy without increasing blood flow rate or dialysis time.