Hemodiálisis extendida frente a convencional o hemodiafiltración en línea: estudio comparativo de necesidad de heparina y coagulación del sistema

• Pelayo-Alonso, Raquel ^[1] ; Cobo-Sánchez, José Luis ^[2] ; Patricia Martínez-Álvarez, Patricia ^[1] ; Portilla-Sánchez, Marta ^[1] ; Ibarguren-Rodríguez, Emilio ^[1]
  1. [1] Hospital Universitario Marqués de Valdecilla

     Hospital Universitario Marqués de Valdecilla

     Santander, España

     
  2. [2] Universidad Católica Santa Teresa de Jesús de Ávila

     Universidad Católica Santa Teresa de Jesús de Ávila

     Ávila, España

     
• Localización: Enfermería Nefrológica, ISSN 2254-2884, Vol. 24, Nº. 3, 2021, págs. 272-277
• Idioma: español
• DOI: 10.37551/S2254-28842021024
• Títulos paralelos:
  • Extended hemodialysis versus conventional or online haemodiafiltration: comparative study of the need for heparin and coagulation of the system
• Enlaces
  • Texto completo
• Resumen
  • español

    Introducción: La reciente aparición de membranas de corte medio ofrece una alternativa para la eliminación de moléculas medianas y nueva terapia dialítica, la hemodiálisis expandida. Estas membranas se caracterizan por un mayor tamaño de poro que podría afectar a la eliminación de la heparina utilizada durante las sesiones de hemodiálisis. Objetivo: Determinar si existen diferencias en la necesidad de heparina y el estado de coagulación del sistema y dializador según técnica dialítica empleada. Material y Método: Estudio cuasiexperimental en pacientes en hemodiálisis con dos periodos de estudio, en el primero, el paciente realizó hemodiálisis convencional o hemodiafiltración y en el segundo, hemodiálisis expandida con membranas de corte medio. Resultados: El dializador quedó parcialmente coagulado en el 10,3% de las sesiones de hemodiálisis expandida frente al 19,1% de las sesiones de hemodiálisis y el 11,4% de hemodiafiltración (p=0,011). Conclusiones: La hemodiálisis expandida ofrece mejor estado de coagulación final del sistema y dializador que otras membranas.

  • English

    Introduction: The recent emergence of medium-cut membranes offers an alternative for the removal of medium-sized molecules and new dialytic therapy, expanded haemodialysis. These membranes are characterised by a larger pore size that could affect the removal of heparin used during hemodialysis sessions. Objective: To determine whether there are differences in the need for heparin and the coagulation status of the system and dialyser according to dialysis technique. Material and Method: Quasi-experimental study in hemodialysis patients with two study periods, in the first, the patient received conventional hemodialysis or haemodiafiltration and in the second, expanded hemodialysis with medium-cut membranes. Results: The dialyser was partially clotted in 10.3% of expanded hemodialysis sessions compared to 19.1% of conventional hemodialysis sessions and 11.4% of haemodiafiltration sessions (p=0.011). Conclusions: Expanded hemodialysis offers better final coagulation status of the system and dialyser than other membranes.

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