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Abstract
Methods: Observational comparative study in a population of 15 chronic hemodialysis patients randomly selected among the patients in our unit. We compared changes in hematological profile, CRP level and vital signs, pre and post hemodialysis, after undergoing both hemodiafiltration techniques. Comparing the differences between the parameters studied before and after each hemodialysis technique.
Results: Platelet levels decreased more in the HDF (HDF -1,33 vs HFR -19,73 x103/mm3, p=0,005). Leukocyte levels decreased in the HDF and increased with HFR (HDF -0,46 vs HFR +0,8 x103/mm3; p=0,006). Regarding the leukocyte formula had mixed results: segmented HDF -1,7 vs HFR +5,4%, p<0,001; lymphocytes HDF +1,96 vs HFR -3,62%, p<0,001. With the HFR decreased CRP levels less (HDF -0,05 vs HFR -0,001 mg/dl; p= NS). Regarding vital signs, systolic blood pressure decreased more in the HFR than HDF (HDF -9,93 vs HFR -10,33 mmHg; p<0,001), conversely that the diastolic blood pressure (HDF -5,2 vs HFR -3 mmHg; p=0,007), and heart rate (HDF -1,46 vs HFR +1,73 lpm; p=NS).
Body temperature increased more with the HDF that the HFR (HDF +0,35 vs HFR +0,06 oC; p=NS).
Conclusions: According to our results the HFR seems more biocompatible than the HDF, probably derived by exogenous reinfusion of HDF.
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Copyright (c) 2012 José Luis Cobo Sánchez, Raquel Pelayo Alonso, Raquel Menezo Viadero, Mª Eugenia Cuadrado Mantecón, Camino Villa Llamazares, Magdalena Gándara Revuelta, Hortensia Cepa García, Mª Araceli Sáez de Buruaga Perea, Mª Elena Incera Setién, Rosa Ana Sainz Alonso, Mª Yolanda Vicente Jiménez, Mª Soraya Sánchez Cano, Mirian García Martínez, Rosa Alonso Nates, Blanca Amelia Paule Peñasco
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References
- Martín Malo A, de Francisco ALM. Dializadores y membranas de diálisis. En: Lorenzo V, López-Gómez JM, de Francisco ALM, Hernández D. Nefrología al día. Madrid: Grupo Editorial Nefrología de la Sociedad Española de Nefrología; 2010. p. 425-435.
- López Gómez JM, Jofré R. Hemodiafiltración en línea. Tratado de hemodiálisis. Segunda edición actualizada. 2006; 13: 287-302.
- Penne EL, Bankestijn PJ, Bots ML, the CONTRAST study group. Effect of increased convective clea-rance by on-line hemodiafiltration on all cause and cardiovascular mortality in chronic haemodialysis patients- the Dutch CONvective TRAnsport Study (CONTRAST): rationale and design of a randomi-zed controlled trail [ISRNCTN38365125]. Curr Control Trials Cardiovasc Med 2005;20(6):8.
- Vaslaski L, Major L, Berta K. On line haemodia-filtration versus haemodialysis; stable haemato-crit with less erythropoietin and improvement of other relevant blood parameters. Blood Purif 2006;24:163-73.
- Altieri P, Sorba G, Bolasco G, Asproni E, Ledebo I, Boström M, et al. Predilution hemofiltration-The second Sardinian Study: comparisons between hemofiltration and haemodialysis during identical Kt/V and sessions times in a long-term crossover study. Nephrol Dial Transplant 2001;16:1207-13.
- Bonforte G, Grillo P, Zerbi S, Surian M. Improve-ment of anemia in hemodialysis patients treated by hemodiafiltration with high volumen on-line-prepa-red substitution fluid. Blood Purif 2002;20:357-63.
- Blankestijn PJ, Ledebo I, Canaud B. Hemodiafil-tration: clinical evidence and remaining questions. Kidney Int 2010;77:581-7.
- Lornoy W, Becaus J, Billiouw M, Sierens L, Van Malderen P, D’Haenens P. On-line haemodiafiltra-tion. Remarkable removal of ß2-microglobulin. Long-term clinical observations. Nephrol Dial Transplant 2000; 15 (Supl. 1): 49-54.
- Grupo de Trabajo del Estudio Multicéntrico Español: Estudio Multicéntrico Español en diálisis corta con membrana de AN 69. Nefrología 1990;10(Supl 3):100-13.
- Locatelli F, Andrulli S, Pecchini F, Pedrini L, Aglia-ta S, Lucchi L, et al. Effect of high-flux dialysis on the anaemia of haemodialysis patients. Nephrol Dial Transplant 2000;15:1399-1409.
- Ismail N. Biochemical mechanisms involved in blood-hemodialysis membrane interactions. UpTo-Date 2011. www.uptodate.com
- Schiffl H, Fischer R, Lang SM, Mangel E. Clinical manifestations of AB-amyloidosis: Effects of biocompatibility and flux. Nephrol Dial Transplant 2000;15:840-5.
- Nakai S, Iseki K, Tabei K, Kubo K, Masakane I, Fushimi K, et al. Outcomes of hemodiafiltration based on Japanese dialysis patient registry. Am J Kidney Dis 2001;38(Suppl 1): S212-S216.
- Álvarez Serrano MD, Ludeña García MJ, Arnau Vives MJ. Nuevas terapias en hemodiálisis: HFR aequilibrium. Rev Soc Esp Enferm Nefrol 2010; 13 (4): 247-251.
- Panichi V, Manca-Rizza G, Paoletti S, Taccola D, Consani C, Filippi C et al. Effects on inflammatory and nutritional markers of haemodiafiltration with online regeneration of ultrafiltrate (HFR) vs on-line haemodiafiltration: a cross-over randomized multicentre trial. Nephrol Dial Transplant. 2006; 21(3):756-62.
- Kim S, Oh KH, Chin HJ, Na KY, Kim YS, Chae DW, Ahn C et al. Effective removal of leptin via hemo-diafiltration with on-line endogenous reinfusion therapy. Clin Nephrol. 2009; 72(6):442-8.
- González-Diez B, Cavia M, Torres G, Abaigar P, Muñiz P. Effect of a hemodiafiltration session with on-line regeneration of the ultrafiltrate on oxidative stress. Comparative study with conven-tional hemodialysis with polysulfone. Blood Purif. 2008;26(6):505-10.
- Calò LA, Naso A, Carraro G, Wratten ML, Pagnin E, Bertipaglia L et al. Effect of haemodiafiltration with online regeneration of ultrafiltrate on oxida-tive stress in dialysis patients. Nephrol Dial Trans-plant. 2007; 22(5):1413-9.
References
Martín Malo A, de Francisco ALM. Dializadores y membranas de diálisis. En: Lorenzo V, López-Gómez JM, de Francisco ALM, Hernández D. Nefrología al día. Madrid: Grupo Editorial Nefrología de la Sociedad Española de Nefrología; 2010. p. 425-435.
López Gómez JM, Jofré R. Hemodiafiltración en línea. Tratado de hemodiálisis. Segunda edición actualizada. 2006; 13: 287-302.
Penne EL, Bankestijn PJ, Bots ML, the CONTRAST study group. Effect of increased convective clea-rance by on-line hemodiafiltration on all cause and cardiovascular mortality in chronic haemodialysis patients- the Dutch CONvective TRAnsport Study (CONTRAST): rationale and design of a randomi-zed controlled trail [ISRNCTN38365125]. Curr Control Trials Cardiovasc Med 2005;20(6):8.
Vaslaski L, Major L, Berta K. On line haemodia-filtration versus haemodialysis; stable haemato-crit with less erythropoietin and improvement of other relevant blood parameters. Blood Purif 2006;24:163-73.
Altieri P, Sorba G, Bolasco G, Asproni E, Ledebo I, Boström M, et al. Predilution hemofiltration-The second Sardinian Study: comparisons between hemofiltration and haemodialysis during identical Kt/V and sessions times in a long-term crossover study. Nephrol Dial Transplant 2001;16:1207-13.
Bonforte G, Grillo P, Zerbi S, Surian M. Improve-ment of anemia in hemodialysis patients treated by hemodiafiltration with high volumen on-line-prepa-red substitution fluid. Blood Purif 2002;20:357-63.
Blankestijn PJ, Ledebo I, Canaud B. Hemodiafil-tration: clinical evidence and remaining questions. Kidney Int 2010;77:581-7.
Lornoy W, Becaus J, Billiouw M, Sierens L, Van Malderen P, D’Haenens P. On-line haemodiafiltra-tion. Remarkable removal of ß2-microglobulin. Long-term clinical observations. Nephrol Dial Transplant 2000; 15 (Supl. 1): 49-54.
Grupo de Trabajo del Estudio Multicéntrico Español: Estudio Multicéntrico Español en diálisis corta con membrana de AN 69. Nefrología 1990;10(Supl 3):100-13.
Locatelli F, Andrulli S, Pecchini F, Pedrini L, Aglia-ta S, Lucchi L, et al. Effect of high-flux dialysis on the anaemia of haemodialysis patients. Nephrol Dial Transplant 2000;15:1399-1409.
Ismail N. Biochemical mechanisms involved in blood-hemodialysis membrane interactions. UpTo-Date 2011. www.uptodate.com
Schiffl H, Fischer R, Lang SM, Mangel E. Clinical manifestations of AB-amyloidosis: Effects of biocompatibility and flux. Nephrol Dial Transplant 2000;15:840-5.
Nakai S, Iseki K, Tabei K, Kubo K, Masakane I, Fushimi K, et al. Outcomes of hemodiafiltration based on Japanese dialysis patient registry. Am J Kidney Dis 2001;38(Suppl 1): S212-S216.
Álvarez Serrano MD, Ludeña García MJ, Arnau Vives MJ. Nuevas terapias en hemodiálisis: HFR aequilibrium. Rev Soc Esp Enferm Nefrol 2010; 13 (4): 247-251.
Panichi V, Manca-Rizza G, Paoletti S, Taccola D, Consani C, Filippi C et al. Effects on inflammatory and nutritional markers of haemodiafiltration with online regeneration of ultrafiltrate (HFR) vs on-line haemodiafiltration: a cross-over randomized multicentre trial. Nephrol Dial Transplant. 2006; 21(3):756-62.
Kim S, Oh KH, Chin HJ, Na KY, Kim YS, Chae DW, Ahn C et al. Effective removal of leptin via hemo-diafiltration with on-line endogenous reinfusion therapy. Clin Nephrol. 2009; 72(6):442-8.
González-Diez B, Cavia M, Torres G, Abaigar P, Muñiz P. Effect of a hemodiafiltration session with on-line regeneration of the ultrafiltrate on oxidative stress. Comparative study with conven-tional hemodialysis with polysulfone. Blood Purif. 2008;26(6):505-10.
Calò LA, Naso A, Carraro G, Wratten ML, Pagnin E, Bertipaglia L et al. Effect of haemodiafiltration with online regeneration of ultrafiltrate on oxida-tive stress in dialysis patients. Nephrol Dial Trans-plant. 2007; 22(5):1413-9.