[Comparative analysis of the efficacy and biocompatibility of various methods of dialysis]
| Autor: | Milenko Zivanovic, Zoran Kovacevic, Svetlana Vujanic, Ljubisa Veljancic, Hrvacević R |
|---|---|
| Rok vydání: | 2005 |
| Předmět: |
Adult
Male medicine.medical_specialty Biocompatibility Adolescent Polymers medicine.medical_treatment Bicarbonate Group ii Urology morbidity Biocompatible Materials Hemodiafiltration methods chemistry.chemical_compound Renal Dialysis Medicine Humans Urea Pharmacology (medical) Sulfones Cellulose Dialysis solutions Aged Kidney lcsh:R5-920 business.industry Cuprophane Membranes Artificial Middle Aged mortality Surgery kidney failure medicine.anatomical_structure Treatment Outcome chemistry Kidney Failure Chronic Female Hemodialysis business lcsh:Medicine (General) |
| Zdroj: | Vojnosanitetski Pregled, Vol 62, Iss 10, Pp 725-729 (2005) |
| ISSN: | 0042-8450 |
| Popis: | Background/Aim. The efficacy and biocompatibility of hemodialysis have a singnificant impact on dialysis patient morbidity and mortality rate. The aim of our study was to compare the efficacy and biocompatibility of different hemodialysis modalities in our patients. Methods. A total of 55 patients were included in the study, and on the basis of dialysis modality, they were divided in four groups: group I - postdilution on-line hemodiafiltration (n = 15), group II - bicarbonate high-flux polysulphone hemodialysis (n = 15), group III - bicarbonate low-flux polysulphone hemodialysis (n = 15), and groupe IV - bicarbonate cuprophane hemodialysis (n = 10). The efficacy was evaluated on the basis of urea reduction rate (URR), urea Kt/V index and serum ?2-microglobuline reduction rate, and the biocompatibility was evaluated on the basis of the leukocyte count fall during the first fifteen minutes of dialysis session, and of the serum C-reactive protein (CRP) level. Results. The highest mean URR was achieved in the group I (70.53 ? 6.49 %), and it was significantly higher in comparison with the average URR in the group IV (54.8 ? 6.35%) (p = 0.001). The average value of urea Kt/V index in the group I (1.48 ? 0.22) was significantly higher in comparison with the average value in the groupe II 1.30 ? 0.22 (p < 0.05), group III (1.05 ? 0.22), and group IV (0.98 + 0.22) (p = 0.001). Serum ?2-microglobuline reduction rate was 68.93 ? 8.25% in the group I, and 58.86 ? 7.98% in the groupe II (p = 0.01). During the first 15 minutes of hemodialysis the leukocyte number was decreased by 12.57 ? 9.35% in the group I, 13.61 ? 9.64% in the group II, 18.3 ? 13.24 in the group III and 62.3 ? 15.4 in the group IV, on average. The mean serum level of CRP was 9.4 ? 6.47 mg/l in the group IV, and less than 3.5 mg/l in the group I of the patients (p = 0.001). Conclusion. Postdilution on-line hemodiafiltration in comparison with standard hemodialysis provided the more effective elimination of small and middle uremic toxins molecules and a significantly higher degree of biocompatibility. The patients treated with standard hemodialysis frequently do not achieve the minimal value of urea Kt/V index prescribed by National Kidney Foundation - Dialysis Outcomes Quality Inatiatives standards. These patients also have significantly higher serum CRP values which suggest the state of chronic microinflammation. |
| Databáze: | OpenAIRE |
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