Comparison of hemodialysis and hemodiafiltration: A long-term longitudinal study

A longitudinal study comparing hemodialysis with long-term hemodiafiltration. Although hemodiafiltration is purported to provide better cardiovascular stability for dialysis patients; other possible benefits of this therapy have not been well defined. We have compared treatment with hemodialysis (HD...

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Bibliographic Details
Published in:Kidney international 1992-04, Vol.41 (4), p.1035-1040
Main Authors: Kerr, Peter B., Argilés, Angel, Flavier, Jean-Louis, Canaud, Bernard, Mion, Charles M.
Format: Article
Language:English
Subjects:
Adult
Aged
Aged, 80 and over
Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy
beta 2-Microglobulin - analysis
Biological and medical sciences
Emergency and intensive care: renal failure. Dialysis management
Evaluation Studies as Topic
Hemofiltration
Humans
Intensive care medicine
Life Sciences & Biomedicine
Longitudinal Studies
Medical sciences
Middle Aged
Renal Dialysis
Science & Technology
Urology & Nephrology
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Summary:A longitudinal study comparing hemodialysis with long-term hemodiafiltration. Although hemodiafiltration is purported to provide better cardiovascular stability for dialysis patients; other possible benefits of this therapy have not been well defined. We have compared treatment with hemodialysis (HD) and hemodiafiltration (HDF) in 20 stable patients over a period of 18 months. Dialysis parameters (dialysate composition and flow, duration, dialyzer) were the same in the two periods except for the added convection of HDF and a higher tolerated blood flow in HDF. Cardiovascular parameters were remarkably similar in the two treatment periods, indicating that stable patients do not benefit furtherfrom this therapy in terms ofthese factors. The clearance of urea was significantly improved with HDF, which was reflected in a higher Kt/V and lower TACurea. We observed a significant correlation between Kt/V and PRU in both HD and HDF modes. This correlation was linear and the regression line was similar in both modes. The clearance of beta2-microglobulin was also significantly improved by HDF compared to HD. Thus the benefit of HDF in stable dialysis patients is the improved clearance of small molecules and beta2-microglobulin without increasing dialysis time. Further clinical benefits due to the improved clearance may only become apparent with longer follow-up.
ISSN:0085-2538
1523-1755
DOI:10.1038/ki.1992.157