Change from conventional haemodiafiltration to on-line haemodiafiltration
Nephrology, Dialysis and Transplantation
urea rebound ) 1.12±0.17 vs 1.26±0.20 (P <0.01), BUN time average concentration ( TAC ) 44.4±9 vs Background. On-line haemodiafiltration (HDF ) is a technique which combines diffusion with elevated con-40.6±10 mg/dl (P <0.05) and protein catabolic rate (PCR) 1.13±0.22 vs 1.13±0.24 g/kg (NS). There was vection and uses pyrogen-free dialysate as a replacement fluid. The purpose of this study was to evaluate a significant increase in haemoglobin (10.66±1.1 vs 11.4±1.5) and haematocrit (32.2±2.9 vs
... 34.0±4.4%), the difference between conventional HDF (1-3 l/h) and on-line HDF (6-12 l/h). P <0.05, during the on-line HDF period, which allowed a decrease in the erythropoietin doses Methods. The study included 37 patients, 25 males and 12 females. The mean age was 56.5±13 years and (3861±2446 vs 3232±2492 UI/week), (P <0.05). Better blood pressure control (MAP 103.8±15 vs duration of dialysis was 62.7±49 months. Three patients dropped out for transplantation, three patients 97.8±11 mmHg, P <0.01) and a lower percentage of patients requiring antihypertensive drugs were also died and three failed to complete the study period. Initially all patients were on conventional HDF with observed. Conclusion. The change from conventional HDF to high-flux membranes over the preceding 34±32 months. Treatment was performed with blood flow on-line HDF results in increased convective removal and fluid replacement (18 l/session). During on-line (QB) 402±41 ml/min, dialysis time ( Td) 187 min, dialysate flow (QD) 654±126 ml/min and replacement HDF treatment, dialysis dose was increased for both small and large molecules with a decrease in uraemic fluid (Qi) 4.0±2 l/session. Patients were changed to on-line HDF with the same filtre and dialysis time, toxicity level ( TAC ). On-line HDF provided a better correction of anaemia with lower dosages of erythro-QD 679±38 ml/min (NS), QB 434±68 ml/min (P <0.05) and post-dilutional replacement fluid poietin. Finally, blood pressure was easily controlled. 22.5±4.3 l/session (P <0.001). We compared conven-Key words: adequate dialysis; convection; conventional tional HDF with on-line HDF over a period of 1 year. haemodiafiltration; on-line haemodiafiltration Dialysis adequacy was monitored according to standard clinical and biochemical criteria. Kinetic analysis of urea and b 2 -micro-globulin ( b 2 m) was performed monthly.