Elevated removal of middle molecules without significant albumin loss with mixed-dilution hemodiafiltration for patients unable to provide sufficient blood flow rates
| Autor: | Pascale Soihan, Jacky Potier, Jean Paul Faucon, Thibault Besselièvre, Eric Renaudineau, Toma Ilinca, Frank Le Roy, Asia Djema, Christian Farquet, Dominique Touzard |
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| Rok vydání: | 2012 |
| Předmět: |
Male
medicine.medical_specialty Treatment outcome Urology Hemodiafiltration Renal Circulation medicine Humans Prospective Studies Renal Insufficiency Chronic Serum Albumin Aged Aged 80 and over Blood Chemical Analysis Chromatography Cross-Over Studies Chemistry Albumin Hematology General Medicine Blood flow Online hemodiafiltration Middle Aged Dilution Treatment Outcome Multicenter study Nephrology Female |
| Zdroj: | Blood purification. 36(2) |
| ISSN: | 1421-9735 |
| Popis: | Background: We examined the hypothesis that mixed-dilution online hemodiafiltration (MIXED) rather than predilution online hemodiafiltration (PRE) could enable patients with low blood flow rate (Qb) to benefit from advantages of convective therapies. Methods: Thirty-eight patients were included in a prospective, randomized, crossover and multicenter study conducted with a view to comparing the equilibrated Kt/V, reduction ratio (RR) of phosphates, β2-microglobulin (β2-M) and myoglobin (myo) between PRE and MIXED, each at two Qb values of 250 and 300 ml/min during 4 h sessions with a FX1000HDF dialyzer. Albumin losses (Alb) were also measured in 12 patients. Results: MIXED was always found to be more efficient compared to PRE notably for middle molecules (MM). RRβ2-M: MIX250: 81.3 ± 3.6 vs. PRE250: 75.2 ± 5.9; MIX300: 82.7 ± 3.6 vs. PRE300: 78.1 ± 5.4; RRmyo: MIX250: 70.2 ± 3.6 vs. PRE250: 42.6 ± 2.6; MIX300: 70.6 ± 3.6 vs. PRE300: 45.7 ± 3.6 and with Alb Conclusion: MIXED allows patients unable to provide sufficiently high Qb to achieve high levels of MM removal. |
| Databáze: | OpenAIRE |
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