Flow balance optimization and fluid removal accuracy with the Quanta SC+ hemodialysis system

ABSTRACT

Background

Fluid management is integral to hemodialysis, both to correct abnormalities in a patient’s plasma composition and to maintain fluid balance. Consequently, accurate net fluid removal during treatment is a critical design element of hemodialysis machines. As dialyzers have evolved, with increased ranges of ultrafiltration coefficients available, it has become more challenging for dialysis machines to minimize errors in flow balance and net fluid removal.

Research design and methods

This paper describes the design, evaluation and experimental performance of the flow balance and ultrafiltration module of the SC+ system to deliver clinically specified fluid removal with both passive and active control measures, in laboratory conditions designed to simulate a wide range of therapies.

Results

The use of passive and active control allows the errors to be minimized across a wider dynamic range of conditions. For the SC+ system, the average flow balance error was 1 mL/hr with an SD of 19 mL/hr and with ultrafiltration it was 13 mL/hr and an SD of 20 ml/hr across all conditions.

Conclusions

This paper demonstrates that the SC+ hemodialysis system, a small, simple and versatile CE marked device, operates within the limits required by international standards across a wide range of experimental conditions.

KEYWORDS:

• Dialyzate
• flow balance
• fluid management
• home hemodialysis
• hemodialysis machine
• ultrafiltration

Article highlights

• Compact and easy to use hemodialysis system for clinic and home use

• State-of-the art flow balancing

• Active and passive flow control measures

• Net fluid removal error average flow balance error was 1 mL/hr with a standard deviation of 19 mL/hr and with ultrafiltration 13 mL/hr across all conditions.

Acknowledgments

These studies were sponsored by Quanta Dialysis Technologies Ltd. All authors accept responsibility for the accuracy of data, its analysis, and the writing of this report.

Declaration of interest

Clive Buckberry, Mark Wallace, and John Milad are employees of Quanta Dialysis Technologies Ltd, Alcester, UK. Nicholas Hoenich is a consultant to Quanta Dialysis Technologies Ltd. Paul Komenda is a consultant nephrologist at the University of Manitoba and Chief Medical Officer of Quanta. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or mater.

Reviewer disclosures

Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Additional information

Funding

This paper was funded by Quanta Dialysis Technologies Ltd.