Korean J Nephrol.  2005 Nov;24(6):885-893.

Clinical Benefits of On-Line Hemodiafiltration in ESRD Patients

• Kim JY
• Han SW
• Park JA
• Yoon JM
• Choi BS
• Yang CW
• Kim YS
• Chang YS
• Bang BK

Abstract

BACKGROUND
On-line hemodiafiltration (HDF) is a novel extracorporeal renal replacement therapy to increase the removal of middle molecules by convection and diffusion. This study was aimed to investigate the clinical benefit of on-line HDF. METHODS: Fifteen stable chronic renal failure patients who were maintaining on low-flux hemodialysis (HD) were switched to on-line HDF for 4 months. Blood pressure, solute clearance rate, anemia, nutrition, cardiac function, inflammatory markers, brain natriuretic peptide and subjective symptoms were compared. RESULTS: In the patients treated with HDF swiching from HD, the episode of intradialytic symptomatic hypotension was significantly decreased. In addition, KT/Vurea and urea reduction ratio as well as beta2-microglobulin clearance rate and reduction ratio were significantly increased, HDF treatment also decreased the pre-dialysis phosphorus levels and daily requirement of calcium carbonate. Furthermore, HDF treatment contributed to the reduction of erythropoietin dose to maintain similar hematocrit levels. Patients' dry weight was increased during HDF treatment without any change of serum albumin and nPCR levels. HDF treatment increased brain natriuretic peptide reduction ratio and improved subjective symptoms such as itching, headache, cramp and insomnia. Inflammatory markers such as hsCRP, IL-1beta, IL-6 and TNF-alpha were not changed by HDF treatment. CONCLUSION: Compared to conventional HD, on-line HDF may offer additional benefits with improved cardiovascular stability, enhanced middle molecule clearance, improvement of anemia and good control of subjective symptoms.

Keyword

Hemodiafiltration; Beta2-microglobulin; Anemia, Nutrition; Inflammation

MeSH Terms

Anemia
Blood Pressure
Calcium Carbonate
Convection
Diffusion
Erythropoietin
Headache
Hematocrit
Hemodiafiltration*
Humans
Hypotension
Inflammation
Interleukin-6
Kidney Failure, Chronic*
Muscle Cramp
Natriuretic Peptide, Brain
Phosphorus
Pruritus
Renal Dialysis
Renal Replacement Therapy
Serum Albumin
Sleep Initiation and Maintenance Disorders
Tumor Necrosis Factor-alpha
Urea
Calcium Carbonate
Erythropoietin
Interleukin-6
Natriuretic Peptide, Brain
Phosphorus
Serum Albumin
Tumor Necrosis Factor-alpha
Urea