Análisis comparativo entre hemodiafiltración en línea frente a hemodiafiltración con reinfusión endógena: parámetros clínico-técnicos e inflamatorios

Abstract

Introduction: Hemodialysis (HD) itself produces a chronic inflammatory process in the patient. Alternative techniques as hemodiafiltration "online" (OL-HDF) improve, among other things, this inflammatory profile. Nowadays, in this research line, new convective techniques are emerging. These techniques could be better than the HDF-OL. Hemodiafiltration with endogenous reinfusion or HFR-SUPRA (HFR) uses a two-chamber dialyzer plus a resin cartridge. In this technique the patient ultrafiltered liquid is subsequently reinfused to its regeneration in this resin cartridge. The aim of our study was to evaluate the differences between the HFR and OL-HDF technique, in terms of clinical and inflammatory parameters and dialysis adequacy. Materials and methods: Sixteen patients were included with a mean age of 61.6 ± 14.5 years. These patients were subjected to the two techniques for periods of eight weeks by the following scheme: HFR-1, HDFOL- 1, HFR-2, HDF-OL-2. All patients underwent highflux HD in the 8 weeks prior. Technical (pressure in the arterial and venous lines, blood flow, treated liter, the infusion volume, and needs of heparin), clinical (systolic and diastolic blood pressure pre and post-dialysis, dry weight, interdialytic weight gain, incidents during the hemodialysis session) and laboratory parameters (elimination of B2m, hemoglobin, hematocrit, albumin) and inflammatory parameters were collected. Results: There was no difference between the two techniques in the collected clinical parameters: systolic and diastolic pre and post-dialysis dry weight, interdialytic weight gain and incidents during the session.