The effect of dialysis needle size on hemodialysis adequacy
Bibliographic record
Abstract
Objective: Dialysis adequacy indexed by Kt/V in hemodialysis (HD) patients is recommended as a single pool Kt/V at least 1.2 per session thrice weekly. But many patients cannot achieve this adequacy target. Although dialysis time is the most important factor influencing Kt/V, 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 73 patients receiving HD thrice weekly for more than 3 months with arteriovenous fistula (AVF) or graft in a single center. Dialysis blood flow rate was 200 ml/min in 12 patients, 250 ml/min in 32 patients, and 300 ml/min in 29 patients. Surface area of dialyzer was 1.2 m2 in 56 patients and 1.6 m2 in 17 patients. We first performed HD using a 16‐gauge needle. 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, or distance between needle insertion sites. We compared compression time after removing the needles, venous dialysis pressure (VDP), Kt/V, and urea reduction ratio (URR) between these two methods. Results: The mean age was 54 ± 13 years and the number of patients with diabetes mellitus was 27 (37%). Fifty‐eight patients (79.5%) have native AVF. Mean Kt/V at HD method using a 15‐gauge needle was higher than at HD method using a 16‐gauge needle (1.30 ± 0.18 vs. 1.23 ± 0.18, p < 0.001). URR at HD method using a 15‐gauge needle was also higher than at HD method using a 16‐gauge needle. In contrast, VDP at HD method using a 15‐gauge needle was lower than at HD method using a 16‐gauge needle (88 ± 22 mmHg vs. 118 ± 28 mmHg, p < 0.001). There was no difference in compression time between the two methods. Conclusion: This study suggests that increasing dialysis needle size is a safe and effective method in improving dialysis adequacy without increasing blood flow rate or dialysis time.
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.002 | 0.013 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.001 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".