{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,18]],"date-time":"2026-09-18T19:38:21Z","timestamp":1789760301775,"version":"4.0.1"},"reference-count":14,"publisher":"SAGE Publications","issue":"5","license":[{"start":{"date-parts":[[2025,5,1]],"date-time":"2025-05-01T00:00:00Z","timestamp":1746057600000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2025,5,1]],"date-time":"2025-05-01T00:00:00Z","timestamp":1746057600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"name":"Outset Medical, Inc."}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Int J Artif Organs"],"published-print":{"date-parts":[[2025,5]]},"abstract":"\n Introduction:<\/jats:title>\n Hemodialysis (HD) represents a necessary medical intervention for patients with end stage kidney disease (ESKD) with a high carbon footprint that significantly consumes natural resources (i.e. water). Reduction of dialysate flow rate is one strategy that directly targets water waste during HD.<\/jats:p>\n <\/jats:sec>\n \n Methods:<\/jats:title>\n \n A retrospective multicenter, observational study was conducted over 12\u2009months in patients with AKI-D and ESKD to evaluate treatments with mid-range dialysate flow rates set at Qd 300\u2009mL\/min (Green HD) using the Tablo\n \u00ae<\/jats:sup>\n HD System (Outset Medical) versus flow rates \u2a7eQd 500\u2009mL\/min (Conventional systems).\n <\/jats:p>\n <\/jats:sec>\n \n Results:<\/jats:title>\n \n One thousand one hundred ninety-five treatments were performed in 433 patients using Green HD (Qd\u2009=\u2009300\u2009mL\/min,\n n<\/jats:italic>\n \u2009=\u2009575) and Conventional systems (Qd \u2a7e500\u2009mL\/min,\n n<\/jats:italic>\n \u2009=\u2009620). Mean Qd for Green HD was 300.0\u2009\u00b1\u20090.0 and mean Qd for the Conventional systems was 686.6\u2009\u00b1\u200988.3\u2009mL\/min. Mean blood flow rates were significantly lower among patients treated with Green HD. Reductions in TACurea and post dialysis serum potassium were similar between the two groups. Estimates for resource utilization were lower using Green HD compared to Conventional systems.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusion:<\/jats:title>\n \n These findings support that higher dialysate flow rates using Conventional systems yield minimal if any benefit in small solute clearance compared to mid-range flow rates. Green HD using the Tablo\n \u00ae<\/jats:sup>\n HD System results in comparable benefits in ESKD patients with significant conservation of water resources.\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1177\/03913988251337228","type":"journal-article","created":{"date-parts":[[2025,5,5]],"date-time":"2025-05-05T04:33:27Z","timestamp":1746419607000},"page":"356-361","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":5,"title":["Utility of a water-sparing approach for reducing dialysate flow rates in hospitalized patients with kidney failure"],"prefix":"10.1177","volume":"48","author":[{"given":"Amay","family":"Parikh","sequence":"first","affiliation":[{"name":"AdventHealth Health System, Orlando, FL, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kirsten","family":"Drake","sequence":"additional","affiliation":[{"name":"Texas Health Harris Methodist Hospital Fort Worth, Fort Worth, TX, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Craig","family":"Woda","sequence":"additional","affiliation":[{"name":"Boston Children\u2019s Hospital, Boston, MA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cynthia","family":"D\u2019Alessandri-Silva","sequence":"additional","affiliation":[{"name":"Outset Medical, Inc., San Jose, CA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0039-3046","authenticated-orcid":false,"given":"Michael","family":"Aragon","sequence":"additional","affiliation":[{"name":"Outset Medical, Inc., San Jose, CA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2025,5,5]]},"reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.1111\/jan.15671"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.1126\/science.1216852"},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.1159\/000321485"},{"key":"e_1_3_3_5_2","doi-asserted-by":"publisher","DOI":"10.1053\/svms.2000.18297"},{"key":"e_1_3_3_6_2","doi-asserted-by":"publisher","DOI":"10.1590\/2175-8239-jbn-2019-0014"},{"key":"e_1_3_3_7_2","volume-title":"Poster presented at the National Kidney Foundation Conference (virtual)","author":"DeSilva R","unstructured":"DeSilva R, Seddon P, Johnstone D, et al. An Academic Hospital\u2019s In-patient Dialysis unit\u2019s staff and patient experience with use of Tablo Hemodialsis System. Poster presented at the National Kidney Foundation Conference (virtual) 6-10 April 2021. Am J Kidney Dis electronic supplement."},{"key":"e_1_3_3_8_2","first-page":"25","article-title":"Real world in-center urea clearance experience with a novel self-care hemodialysis system","volume":"22","author":"Alvarez, L and Chertow, G","year":"2018","unstructured":"Alvarez, L and Chertow, G. Real world in-center urea clearance experience with a novel self-care hemodialysis system. Hemodial Int 2018; 22: 25. abstract.","journal-title":"Hemodial Int"},{"key":"e_1_3_3_9_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0272-6386(12)80073-4"},{"key":"e_1_3_3_10_2","doi-asserted-by":"publisher","DOI":"10.2215\/CJN.02630311"},{"key":"e_1_3_3_11_2","first-page":"189","volume-title":"Updates in hemodialysis","author":"Ahrenholz P","unstructured":"Ahrenholz P, Winkler RE, Zendeh-Zartochti D. The role of the dialysate flow rate in haemodialysis. In K Suzuki (ed.) Updates in hemodialysis, Medicine, pp.189\u2013198."},{"key":"e_1_3_3_12_2","doi-asserted-by":"publisher","DOI":"10.1097\/01.MAT.0000104824.55517.6C"},{"key":"e_1_3_3_13_2","unstructured":"United States Renal Data System. 2023 USRDS Annual Data Report: Epidemiology of kidney disease in the United States. National Institutes of Health National Institute of Diabetes and Digestive and Kidney Diseases Bethesda MD 2023."},{"key":"e_1_3_3_14_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(14)61601-9"},{"key":"e_1_3_3_15_2","doi-asserted-by":"publisher","DOI":"10.1038\/s41581-019-0245-1"}],"container-title":["The International Journal of Artificial Organs"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/03913988251337228","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/03913988251337228","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/03913988251337228","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,29]],"date-time":"2026-04-29T19:41:22Z","timestamp":1777491682000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/03913988251337228"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,5]]},"references-count":14,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2025,5]]}},"alternative-id":["10.1177\/03913988251337228"],"URL":"https:\/\/doi.org\/10.1177\/03913988251337228","relation":{},"ISSN":["0391-3988","1724-6040"],"issn-type":[{"value":"0391-3988","type":"print"},{"value":"1724-6040","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,5]]}}}