Factors associated with albumin loss in post-dilution hemodiafiltration and nutritional consequences
| Autor: | Jean-Michel Halimi, Louis Prat, Béatrice Birmelé, Anne Fournier, Maud François |
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| Rok vydání: | 2015 |
| Předmět: |
Male
medicine.medical_specialty Treatment outcome Biomedical Engineering Serum albumin Medicine (miscellaneous) Nutritional Status Bioengineering Serum Albumin Human Hemodiafiltration Gastroenterology Post-dilution Transmembrane pressure Biomaterials Risk Factors Internal medicine Medicine Humans Prospective Studies Prospective cohort study Serum Albumin Aged Nutrition assessment biology business.industry Albumin Nutritional status Membranes Artificial General Medicine Equipment Design Middle Aged Nutrition Assessment Treatment Outcome biology.protein Female Kidney Diseases France business Biomarkers |
| Zdroj: | The International journal of artificial organs. 38(2) |
| ISSN: | 1724-6040 |
| Popis: | Introduction Hemodiafiltration is currently one of the most effective techniques of extra-renal purification but results in an increase of albumin loss in dialysate. We aimed to determine the factors associated with albumin loss during post-dilution hemodiafiltration, compare an “automatic” mode of infusate flow control versus a “manual” control, and assess the potential nutritional impact. Methods This prospective observational study included all hemodialysis patients in our institution who underwent post-dilution hemodiafiltration 3 times a week on a Fresenius 5008 for at least 2 months. At each session, albumin content was measured in a representative effluent dialysate volume. The automatic mode of the Fresenius 5008 was used for automatic infusate flow control. Results In all, 18 patients (mean age 60.7 ± 15 years) underwent 85 post-dilution hemodiafiltration sessions. The mean albumin loss was 3134 ± 2450 mg/session. Albumin loss was significantly affected by infusate flow, infusate volume, transmembrane pressure and ultrafiltration volume. The loss was greater with Toraysulfone and FX 1000 membranes rather than FX 80 or FX 100 membranes. With AutoSub rather than manual control, infusate flow was greater ( PConclusions Albumin loss during post-dilution hemodiafiltration was correlated with increased transmembrane pressure and infusate flow, especially AutoSub flow control, and type of membrane. However, this loss, when moderate, did not seem to affect nutritional aspects and should not limit the use of hemodiafiltration. |
| Databáze: | OpenAIRE |
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