Inflow time and recirculation in single-needle hemodialysis. 1986

S S Blumenthal, and M A Ortiz, and J G Kleinman, and W F Piering

The recirculation of previously dialyzed blood in the lumen of the single-needle catheter reduces dialysis efficiency and is a drawback of single-needle dialysis. We reasoned that using maneuvers that would augment the volume of blood drawn in during the inflow phase of each dialytic cycle would decrease recirculation. We tested this hypothesis by progressively lengthening the inflow time and measuring the recirculation rate in three patients undergoing single-needle hemodialysis with a single-lumen subclavian hemodialysis catheter during five separate dialyses. Inflow time was varied with a time-time single-needle device (Gambro SN-10-2D). Percentage recirculation decreased progressively from 23% +/- 3% at an inflow time of 1 second to 7% +/- 2% at an inflow time of 4 seconds (P less than .03, n = 5). With a time-time single-needle device, recirculation did not vary, with a change in pump speed from 106 to 250 mL/min (8.2% v 8.4%, n = 6). With other single-needle devices, however, inflow time varied inversely with pump speed, and at higher pump speeds, recirculation tended to increase, although not uniformly, in every patient. Maximizing the inflow volume is essential for minimizing recirculation in single-needle hemodialysis. Clinically insignificant recirculation ensues when inflow time is maintained between 3 to 5 seconds and time-time single-needle devices are used, even in patients dialyzed with single-lumen subclavian catheters.

UI MeSH Term Description Entries
D008297 Male Males
D008875 Middle Aged An adult aged 45 - 64 years. Middle Age
D001783 Blood Flow Velocity A value equal to the total volume flow divided by the cross-sectional area of the vascular bed. Blood Flow Velocities,Flow Velocities, Blood,Flow Velocity, Blood,Velocities, Blood Flow,Velocity, Blood Flow
D006435 Renal Dialysis Therapy for the insufficient cleansing of the BLOOD by the kidneys based on dialysis and including hemodialysis, PERITONEAL DIALYSIS, and HEMODIAFILTRATION. Dialysis, Extracorporeal,Dialysis, Renal,Extracorporeal Dialysis,Hemodialysis,Dialyses, Extracorporeal,Dialyses, Renal,Extracorporeal Dialyses,Hemodialyses,Renal Dialyses
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000293 Adolescent A person 13 to 18 years of age. Adolescence,Youth,Adolescents,Adolescents, Female,Adolescents, Male,Teenagers,Teens,Adolescent, Female,Adolescent, Male,Female Adolescent,Female Adolescents,Male Adolescent,Male Adolescents,Teen,Teenager,Youths
D000328 Adult A person having attained full growth or maturity. Adults are of 19 through 44 years of age. For a person between 19 and 24 years of age, YOUNG ADULT is available. Adults
D000368 Aged A person 65 years of age or older. For a person older than 79 years, AGED, 80 AND OVER is available. Elderly
D013997 Time Factors Elements of limited time intervals, contributing to particular results or situations. Time Series,Factor, Time,Time Factor

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