Phosphate addative

[John Barnes]

Does anyone have any experiance with adding Cleen Phosphate solution to their concentrates, primarily when used on AK95 machines, giving conductivity and flow errors long term

[Ian Wilde]

Hi John, we have used it on our 5008 machines by adding a fleet enemer to the acid with no side effects whatsoever.

[Chris Bates]

Hi John,
We are probably going to start using this too. I believe Cleen is the new name for Fleet enema.
Lizzie Lindley is probably the person to start with since she was working on draft guidelines for this sort of thing.
Chris

[Chris Pearson]

Could somebody enlighten those of us who have no idea what this is for ?

[John Barnes]

thanks for the replies gents, we've been using it for a while now with no side affects on patients but a few of our AK95's are giving us problems with conductivity which dissappears when we change the concentrate for fresh non additive cans. For your info Chris we add it to concentrate to boost the patients Phosphate levels

[Ian Wilde]

Something I was involved with from a technical point of view:

https://www.research.manchester.ac.uk/portal/en/publications/phosphate-enrichment-of-dialysate-for-use-in-standard-and-extended-haemodialysis(1085c38e-7f5d-482a-bd3f-e0165648cfc6)/export.html

[John Barnes]

Thank you Ian, from what I can see from information gathered it works fine with 5008's,but i've not heard of anyone using it with Gambro machines

[Chris Pearson]

Thanks John,and here's me thinking it was for constipated patients.
If there is enough interest we could look at asking MTN adding it to their formulation list.
BR
Chris

[Onkar Singh]

Hi Ian

 

Wish I had known about this paper before we added fleet to concentrate.

I did advise the consultant who requested this that we will be going off-label and we carried out frequent sample analysis to ensure sample contents were stable.

 

Kind regards,

Onkar Singh | Chief Clinical Technologist/Section Head – Renal | Medical Physics & Clinical Engineering      

::  Emai       [hidden email]

(:  Tele        01902 69 5468 or 01902 307999 Ext: 6144 or Bleep: 7790

*: Add        The Royal Wolverhampton NHS Trust, The Deanesly Centre, C35, New Cross Hospital, Wednesfield Road, Wolverhampton WV10 0QP

 

From: Ian Wilde [via ART Forum] [mailto:ml+[hidden email]]
Sent: 11 July 2018 15:46
To: SINGH, Onkar (THE ROYAL WOLVERHAMPTON NHS TRUST)
Subject: Re: Phosphate addative

 

Something I was involved with from a technical point of view:

https://www.research.manchester.ac.uk/portal/en/publications/phosphate-enrichment-of-dialysate-for-use-in-standard-and-extended-haemodialysis(1085c38e-7f5d-482a-bd3f-e0165648cfc6)/export.html

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[Chris Bates]

Does anyone do this for HDF treatments ?

[Ian Wilde]

I think all our data was collected during HDF treatments Chris.  I know the paper that was done mentions HD but I don't think it was specifically meaning the it was only done on standard HD mode.  As HDF replacement is just filtered dialysate anyway the phosphate rich fluid is being infused directly into the patient bloodstream if you were perhaps worried about it being dialysed out or something?

[Chris Pearson]

I've just had a reply from MTN and they had already been asked by another customer and unfortunately have said no because of the additional costs of all the solution testing.
Perhaps if the numbers grow considerably they might reconsider.