Mixed hemodiafiltration reduces erythropoiesis stimulating agents requirement in dialysis patients: a prospective randomized study
| Autor: | L. Pedrini, Mario Comelli, Mauro Pezzotta, Attilio Di Benedetto, Guido Gatti, Pio Ruggiero, Vania Manfrini, Annalisa Feliciani, Laura Auriemma, Giorgio Cozzi, Stefano Stuard, Marta Arazzi, Angelo Castellano |
|---|---|
| Rok vydání: | 2019 |
| Předmět: |
Nephrology
medicine.medical_specialty Darbepoetin alfa Anemia medicine.medical_treatment 030232 urology & nephrology Hemodiafiltration 030204 cardiovascular system & hematology law.invention 03 medical and health sciences Hemoglobins 0302 clinical medicine Randomized controlled trial law Renal Dialysis hemic and lymphatic diseases Internal medicine medicine Humans Prospective Studies Dialysis integumentary system business.industry medicine.disease Erythropoietin Hematinics Erythropoiesis Hemodialysis business medicine.drug |
| Zdroj: | Journal of nephrology. 33(5) |
| ISSN: | 1724-6059 |
| Popis: | Improved responsiveness to erythropoiesis stimulating agents (ESAs) in patients on on-line post-dilution hemodiafiltration (Post-HDF) compared with conventional hemodialysis (HD) was reported by some authors but challenged by others. This prospective, cross-over randomized study tested the hypothesis that an alternative infusion modality of HDF, mixed-dilution HDF (Mixed HDF), could further reduce ESAs requirement in dialysis patients compared to the traditional Post-HDF. One-hundred-twenty prevalent patients from 6 Dialysis Centers were randomly assigned to two six-months treatment sequences: A–B and B–A (A, Mixed HDF; B, Post-HDF). Primary outcome was comparative evaluation of ESA (darbepoetin alfa) requirement and ESA resistance. Treatments efficiency, iron and vitamins status, inflammation and nutrition parameters were monitored. In sequence A, darbepoetin requirement decreased during Mixed HDF from 29.5 to 23.7 µg/month and increased significantly during Post-HDF (32.3 µg/month at 6th month) while, in sequence B, it increased during Post-HDF from 38.2 to 43.7 µg/month and decreased during Mixed HDF (23.9 µg/month at 6th month). Overall, EPO doses at 6 months on Mixed and Post-HDF were 23.8 and 38.4 µg/month, respectively, P |
| Databáze: | OpenAIRE |
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