Open Access, Peer-reviewed
pISSN 2233-7385
eISSN 2233-7393
    Chonnam Med J. 2010 Apr;46(1):44-48. Korean.
    Published online Apr 15, 2010.
    https://doi.org/10.4068/cmj.2010.46.1.44
    Copyright © 2010 Chonnam National University Medical School
    Original Article

    The Short-term Efficacy and Safety of On-line Hemodiafiltration

    Hyung-Chul Lee, Joon-Suk Choi, Dae-Hun Lim, Ji-Min Jeong, Pyung-Kyun Park, An-Doc Jung, Myong-Yun Nah and Nam-ho Kim
      • Department of Internal Medicine, Chonnam National University Hospital, Gwangju, Korea.
    • Corresponding author (Email: nhk111@chonnam.ac.kr )
    Received January 09, 2010; Accepted February 04, 2010.

    Abstract

    Online hemodiafiltration (online HDF) is a new hemodialysis technique that is capable of purifying not only small but also medium- to large-sized molecules. This study aimed to prove the short-term efficacy and safety of online HDF. Between January 2008 and January 2009, a total of 23 patients (56±13 years, male 56.5%) on high-flux hemodialysis (HF-HD) for at least 3 months were switched to online HDF in the predilution mode. Before and after the patients were switched to online HDF, we checked the frequency of hypotension during hemodialysis, subjective symptoms, and a biochemical marker [beta 2-microglobulin (β2-MG)]. There was no increase in the frequency of hypotension during online HDF. No patients in either group developed a fever or were hospitalized. There were improvements in subjective symptoms including fatigue, clamp, and headache, whereas there was no significant change in laboratory findings (hemoglobin, hematocrit, protein, albumin, Ca, P, K, parathyroid hormone, and β2-MG). Online HDF revealed no significant changes in dialysis adequacy (Kt/V: 1.68±0.28 in HF-HD vs. 1.63±0.44 in online HDF). In conclusion, online HDF improved subjective symptoms and was safe and adequate, but there was no improvement in laboratory findings.

    Keywords
    Hemodiafiltration; Beta 2-microglobulin; Safety

    Tables

    Table 1
    Baseline characteristics

    Table 2
    Subjective symptoms before and after on-line hemodiafiltation

    Table 3
    Biochemical changes before and after on-line hemodiafiltation

    References

      1. Kachel HG, Altmeyer P, Baldamus CA, Koch KM. Deposition of an amyloid-like substance as a possible complication of regular dialysis treatment. Contrib Nephrol 1983;36:127–132.
      1. Gejyo F, Narita I. Current clinical and pathogenetic understanding of beta2-m amyloidosis in long-term haemodialysis patients. Nephrology (Carlton) 2003;8 Suppl:S45–S49.
      1. Ahrenholz PG, Winkler RE, Michelsen A, Lang DA, Bowry SK. Dialysis membrane-dependent removal of middle molecules during hemodiafiltration: the beta2-microglobulin/albumin relationship. Clin Nephrol 2004;62:21–28.
      1. Henderson LW, Colton CK, Ford CA. Kinetics of hemodiafiltration. II. Clinical characterization of a new blood cleansing modality. J Lab Clin Med 1975;85:372–391.
      1. Locatelli F, Di Filippo S, Manzoni C. Removal of small and middle molecules by convective techniques. Nephrol Dial Transplant 2000;15 Suppl 2:S37–S44.
      1. Maduell F, del Pozo C, Garcia H, Sanchez L, Hdez-Jaras J, Albero MD, et al. Change from conventional haemodiafiltration to on-line haemodiafiltration. Nephrol Dial Transplant 1999;14:1202–1207.
      1. Maduell F, Navarro V, Cruz MC, Torregrosa E, Garcia D, Simon V, et al. Osteocalcin and myoglobin removal in on-line hemodiafiltration versus low- and high-flux hemodialysis. Am J Kidney Dis 2002;40:582–589.
      1. Canaud B, Bosc JY, Leray H, Stec F, Argiles A, Leblanc M, et al. On-line haemodiafiltration: state of the art. Nephrol Dial Transplant 1998;13 Suppl 5:S3–S11.
      1. Canaud B, Nguyen QV, Polito C, Stec F, Mion C. Hemodiafiltration with on-line production of bicarbonate infusate. A new standard for high-efficiency, low-cost dialysis in elderly and uncompliant patients. Contrib Nephrol 1989;74:91–100.
      1. Kerr PB, Argilés A, Flavier JL, Canaud B, Mion CM. Comparison of hemodialysis and hemodiafiltration: a long-term longitudinal study. Kidney Int 1992;41:1035–1040.
      1. Lornoy W, Becaus I, Billiouw JM, Sierens L, Van Malderen P, D'Haenens P. On-line haemodiafiltration. Remarkable removal of beta2-microglobulin. Long-term clinical observations. Nephrol Dial Transplant 2000;15 Suppl 1:S49–S54.
      1. Kim JY, Han SW, Park JA, Yoon JM, Choi BS, Yang CW, et al. Clinical experience of on-line hemodiafiltration. Korean J Nephrol 2005;24 suppl 2:S456–S464.
      1. Hillion D HT, Colas F, Stoll E. Microbiological quality of substitution fluid(SF) using AK100 Ultra 28th annual meeting of ASN; 1995. pp. 490.
      1. Merabet E, Dagogo-Jack S, Coyne DW, Klein S, Santiago JV, Hmiel SP, et al. Increased plasma leptin concentration in end-stage renal disease. J Clin Endocrinol Metab 1997;82:847–850.
      1. Canaud B, Bosc JY, Leray-Moragues H, Stec F, Argiles A, Leblanc M, et al. On-line haemodiafiltration. Safety and efficacy in long-term clinical practice. Nephrol Dial Transplant 2000;15 Suppl 1:S60–S67.
      1. Shin JA, Jang EH, Baek H, Choi SY, Kim MO, Lee JE, et al. The changes of Clinical Marker, beta2-microglobulin and Oxidized LDL, after Converting to On-Line Hemodiafiltration from High-flux Hemodialysis. Korean J Nephrol 2008;27:62–69.
      1. Lin CL, Huang CC, Yu CC, Wu CH, Chang CT, Hsu HH, et al. Improved iron utilization and reduced erythropoietin resistance by on-line hemodiafiltration. Blood Purif 2002;20:349–356.
      1. Odell RA, Slowiaczek P, Moran JE, Schindheim K. B2-microglobulin kinetics in end-stage renal failure. Kidney Int 1991;39:909–919.
    MeSH Terms
    Biomarkers
    Dialysis
    Fatigue
    Fever
    Headache
    Hematocrit
    Hemodiafiltration
    Humans
    Hypotension
    Male
    Parathyroid Hormone
    Renal Dialysis
    beta 2-Microglobulin
    Metrics
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    Tables
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