Korean J Nephrol.
2008 Jan;27(1):62-69.
The Changes of Clinical Markers, beta2-microglobulin and Oxidized LDL, after Converting to On-line Hemodiafiltration from High-flux Hemodialysis
- Affiliations
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- 1Department of Internal Medicine, Samsung Medical Center, College of Medicine, Sungkyunkwan University, Seoul, Koera. ygkim26@skku.edu
- 2Department of Interna Medicine, College of Medicine, Cheju National University, Cheju, Korea.
- 3Department of Internal Medicine, College of Medicine, Kangwon National University, Chuncheon, Korea.
- 4Department of Internal Medicine, College of Medicine, Eulji University, Daejeon, Korea.
Abstract
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PURPOSE: Hemodiafiltration with the on-line regeneration of ultrafiltrate (on-line hemodiafiltration, OL- HDF) provides better clearance of both small and large solutes than high-flux hemodialysis (HFHD) and may reduce inflammation and oxidative stress. The purpose of this observational study was to ascertain whether OL-HDF improves clinical markers after switching from HFHD to OL-HDF in patients with end-stage renal disease.
METHODS
Fourteen stable patients on HFHD for at least 6 months were switched to OL-HDF. We observed changes in subjective symptoms, the levels of hemoglobin, erythropoietin dose, Kt/V, URR, beta 2-microglobulin, plasma oxidized LDL (OxLDL) and CRP for twelve-months period.
RESULTS
There were improvements in subjective symptoms including fatigue, anorexia, insomnia and itching sensation (p<0.05). There were significant increases in Kt/V (1.63+/-0.17 vs. 1.77+/-0.24, p< 0.05) and URR (75.1+/-3.2 vs. 77.2+/-3.9%, p<0.05). Even though erythropoietin dose was not changed, hemoglobin level was increased (10.6+/-1.3 vs. 11.4+/-1.0, p<0.05). Beta 2-microglobulin clearance was significantly increased (17.7+/-4.4 vs. 21.9+/-6.1 mL/min, p<0.05). However, the pre-dialysis level of beta 2-microglobulin was not significantly reduced. The pre-dialysis level of CRP was not changed. OxLDL reduction ratio was not changed. On the other hand, the pre-dialysis plasma level of OxLDL was significantly reduced (32.36+/-6.03 vs. 26.05+/-6.00 U/L, p<0.05).
CONCLUSION
OL-HDF improved several subjective symptoms, anemia, the clearance of small solute, beta 2-microglobulin level and reduced plasma OxLDL after switching from HFHD. Less OxLDL may be generated in OL-HDF compared with HFHD.
MeSH Terms
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Anemia
Anorexia
beta 2-Microglobulin
Biomarkers
Erythropoietin
Fatigue
Hand
Hemodiafiltration
Hemoglobins
Humans
Inflammation
Kidney Failure, Chronic
Lipoproteins, LDL
Oxidative Stress
Plasma
Pruritus
Regeneration
Renal Dialysis
Sensation
Sleep Initiation and Maintenance Disorders
Erythropoietin
Hemoglobins
Lipoproteins, LDL
beta 2-Microglobulin
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