Short-term effects of hemodiafiltration versus conventional hemodialysis on erythrocyte performance
Canadian Journal of Physiology and Pharmacology
Hemodiafiltration (HDF) is a renal replacement therapy which is based on the principles of diffusion and convection for the elimination of uremic toxins. A significant and increasing number of end stage renal disease (ESRD) patients are treated with HDF, even in the absence of definite and conclusive survival and anemia treatment data. However, its effects on red blood cell (RBC) physiological features have not been examined in depth. In this study, ESRD patients under regular HDF or
... r HDF or conventional hemodialysis (cHD) treatment were examined for RBC-related parameters, including anemia, hemolysis, cell shape, redox status, removal signaling, membrane protein composition and microvesiculation, in repeated paired measurements accomplished before and right after each dialysis session. HDF-group was characterized by better redox potential and suppressed exovesiculation of blood cells compared to the cHD-group pre-dialysis. However, HDF was associated with a temporary but acute, oxidative stress-driven increase in hemolysis, RBC removal signaling and stomatocytosis, probably associated with the effective clearance of dialyzable natural antioxidant components, including uric acid, from the uremic plasma. The nature of these adverse short-term effects of HDF on post-dialysis plasma and RBCs strongly suggests the use of a parallel antioxidant therapy during the HDF session.