Document Detail


Change from three times a week on-line hemodiafiltration to short daily on-line hemodiafiltration.
MedLine Citation:
PMID:  12787423     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Daily dialysis has shown excellent clinical results because a higher frequency of dialysis is more physiologic. On-line hemodiafiltration (OL-HDF) is a HDF technique that combines diffusion with high convection in which the dialysis fluid itself is used as a reinfusion solution. The aim of this study was to demonstrate the beneficial effect of the more effective dialysis schedule (daily dialysis) with the dialysis modality that offers the highest uremic toxin removal (on-line HDF). METHODS: Eight patients, six males and two females, on standard 4 to 5 hours three times a week OL-HDF (S-OL-HDF) were switched to daily OL-HDF (D-OL-HDF) 2 to 21/2 hours six times per week. Dialysis parameters were identical during both periods and only frequency and dialysis time of each session were changed. Tolerance, uremic toxin removal, urea kinetics, biochemical and anemia profiles, blood pressure, and left ventricular hypertrophy were evaluated. RESULTS: D-OL-HDF was well accepted and tolerated. The disappearance of postdialysis fatigue was rapidly reported by patients. Patients mantained the same [time average concentration (TAC) and weekly single-pool Kt/V (spKt/V)] throughout the study. However, equivalent renal urea clearance (EKR), standard Kt/V and weekly urea reduction ratio (URR) were increased during D-OL-HDF. Weekly urea, creatinine, osteocalcin, beta2-microglobulin, myoglobin, and prolactin reduction ratios were improved with D-OL-HDF. There was a significant decrease in predialysis plasma levels of urea, creatinine, acid uric, beta2-microglobulin and homocysteine over 6 months. Phosphate binders were reduced and antihypertensive drugs were stopped. A 30% regression of left ventricular mass was observed. CONCLUSION: The change from S-OL-HDF to D-OL-HDF was well tolerated. Disappearance of postdialysis fatigue, better dialysis adequacy, a higher removal of middle and large molecules, a reduction of phosphate binders, improvement of status nutritional, and an important reduction of cardiovascular risk factors were observed.
Authors:
Francisco Maduell; Victor Navarro; Eduardo Torregrosa; Asunción Rius; Fernando Dicenta; Maria Carmen Cruz; J Antonio Ferrero
Related Documents :
6365233 - Comparison of hexabrix 320 and conray 420 for left ventriculography in patients with co...
12353833 - Preservation of portal pressure improves growth and metabolic profile in the male porta...
2627503 - Guidelines for home air-fluidized bed therapy, 1989.
Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Kidney international     Volume:  64     ISSN:  0085-2538     ISO Abbreviation:  Kidney Int.     Publication Date:  2003 Jul 
Date Detail:
Created Date:  2003-06-05     Completed Date:  2004-03-19     Revised Date:  2008-11-21    
Medline Journal Info:
Nlm Unique ID:  0323470     Medline TA:  Kidney Int     Country:  United States    
Other Details:
Languages:  eng     Pagination:  305-13     Citation Subset:  IM    
Affiliation:
Department of Nephrology, Hospital General de Castellón, Spain. maduell_fra@gva.es
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Blood Pressure
Blood Urea Nitrogen
Female
Heart / physiopathology
Hemodiafiltration*
Humans
Hypertrophy, Left Ventricular / diagnosis
Kidney Diseases / physiopathology,  therapy*
Kinetics
Magnetic Resonance Imaging
Male
Middle Aged
Nutritional Physiological Phenomena
Population Surveillance
Single-Blind Method
Time Factors
Treatment Outcome

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


Previous Document:  The cost-effectiveness of maintaining higher hemoglobin targets with erythropoietin in hemodialysis ...
Next Document:  Cytokine single nucleotide polymorphisms and intrarenal gene expression in chronic allograft nephrop...