| Change from three times a week on-line hemodiafiltration to short daily on-line hemodiafiltration. | |
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MedLine Citation:
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PMID: 12787423 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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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. |
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Authors:
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Francisco Maduell; Victor Navarro; Eduardo Torregrosa; Asunción Rius; Fernando Dicenta; Maria Carmen Cruz; J Antonio Ferrero |
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Publication Detail:
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Type: Journal Article; Research Support, Non-U.S. Gov't |
Journal Detail:
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Title: Kidney international Volume: 64 ISSN: 0085-2538 ISO Abbreviation: Kidney Int. Publication Date: 2003 Jul |
Date Detail:
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Created Date: 2003-06-05 Completed Date: 2004-03-19 Revised Date: 2008-11-21 |
Medline Journal Info:
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Nlm Unique ID: 0323470 Medline TA: Kidney Int Country: United States |
Other Details:
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Languages: eng Pagination: 305-13 Citation Subset: IM |
Affiliation:
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Department of Nephrology, Hospital General de Castellón, Spain. maduell_fra@gva.es |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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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
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