Document Detail


On-line predilution hemofiltration versus ultrapure high-flux hemodialysis: a multicenter prospective study in 23 patients. Sardinian Collaborative Study Group of On-Line Hemofiltration.
MedLine Citation:
PMID:  9262843     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
The aims of the present prospective multicenter study were to assess the clinical tolerance and well being, the correlation between nPCr and Kt/V and the pretreatment beta 2-microglobulin level in patients sequentially treated with high-flux dialysis with ultrapure bicarbonate hemodialysis (HD; phase 1) and predilution hemofiltration (HF) with on-line prepared bicarbonate substitution fluid (phase II). The same monitor (Gambro AK 100 ULTRA) and membrane (polyamide) were used. Twenty-three patients, all in a stable clinical condition, entered the study. The treatment was targeted to an equilibrated Kt/V (eqKt/V) of 1.4 for HD and 1.0 for HF. No mortality or relevant morbidity were observed. The number of hypotensive episodes was 1.78 +/- 2.8 per patient and month during HD vs. 1.17 +/- 3.1 during HF (p = 0.003) and the number of the hypertensive episodes 1.28 +/- 2.8 during HD vs. 0.42 +/- 0.8 during HF (p = 0.04). Incidences of arrhythmia, muscular cramps and headache were significantly less frequent during HF. Interdialytic cramps, arthralgia and fatigue were also significantly less frequent during the HF period. The average beta 2-microglobulin level was 27.1 +/- 14.7 mg/dl at the start of the study, 22.9 +/- 4.9 mg/dl at the beginning of phase II and 22.4 +/- 4 mg/dl at the end of phase II (p = 0.01 compared to the start). A significant linear correlation between the normalized protein catabolic rate and eqKt/V was obtained faster during HD than during HF (45 vs. 120 days) indicating that HF affects the nutritional status with mechanisms different from HD. The present study is in agreement with the hypothesis that HF gives and adequate nutritional status with improved clinical stability and well being at a lower Kt/V compared to HD. Both therapies were efficient in controlling the pretreatment beta 2-microglobulin level.
Authors:
P Altieri; G B Sorba; P G Bolasco; M Bostrom; E Asproni; R Ferrara; F Bolasco; M Cossu; F Cadinu; G F Cabiddu; D Casu; M Ganadu; M Passaghe; M Pinna
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Publication Detail:
Type:  Clinical Trial; Comparative Study; Journal Article; Multicenter Study; Randomized Controlled Trial    
Journal Detail:
Title:  Blood purification     Volume:  15     ISSN:  0253-5068     ISO Abbreviation:  Blood Purif.     Publication Date:  1997  
Date Detail:
Created Date:  1997-10-28     Completed Date:  1997-10-28     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  8402040     Medline TA:  Blood Purif     Country:  SWITZERLAND    
Other Details:
Languages:  eng     Pagination:  169-81     Citation Subset:  IM    
Affiliation:
Divisione Nefrologie e Dialisi, Ospedale S. Michele, Cagliari, Italy. btonio@mbox.vol.it
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MeSH Terms
Descriptor/Qualifier:
Aged
Arrhythmias, Cardiac / etiology
Bicarbonates / administration & dosage,  adverse effects
Body Weight
Electrolytes / blood
Fatigue / etiology
Female
Gastrointestinal Diseases / etiology
Hemodialysis Solutions / administration & dosage,  adverse effects
Hemofiltration / adverse effects,  methods*
Humans
Hypotension / etiology
Kidney Failure, Chronic / complications,  therapy*
Male
Middle Aged
Pain / etiology
Prospective Studies
Proteins / metabolism
Renal Dialysis / adverse effects,  methods*
Urea / blood
beta 2-Microglobulin / analysis
Chemical
Reg. No./Substance:
0/Bicarbonates; 0/Electrolytes; 0/Hemodialysis Solutions; 0/Proteins; 0/beta 2-Microglobulin; 57-13-6/Urea

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


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