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On-line hemodiafiltration in Southeast Asia: a three-year prospective study of a single center.

Abstract
Growing evidence suggests the superiority of on-line hemodiafiltration (HDF) compared with the conventional hemodialysis technique in many aspects; however, on-line HDF is still not used worldwide, including in Southeast Asia. The purpose of this study is to compare various clinical outcomes between on-line HDF and high-flux hemodialysis (HFHD). This was a single-center three-year prospective observational study that demonstrated the clinical parameters after switching from HFHD to on-line HDF in 22 HDF patients, whose average age was 58.1 +/- 13.3 years. The incidence of intradialytic undesired events, including hypotension, decreased and an apparent increase in appetite and an improvement in overall well-being were recorded by most patients after switching to on-line HDF. The data for dry weight, body mass index, and normalized protein nitrogen appearance, which represent nutritional status, showed a significant improvement while still maintaining a satisfactory albumin level. The adequacy in terms of urea reduction ratio significantly increased. The serum predialysis beta(2)-microglobulin levels were reduced by 25.7% from 31.1 +/- 3.1 to 23.1 +/- 4.8 mg/L (P < 0.05) at six months and remained constant during the three years of follow-up. The patients' lipid profile was well controlled, and the mean C-reactive protein value was still maintained in the normal range. In conclusion, our three-year experience showed that on-line HDF is a well-tolerated treatment with a lower incidence of intradialytic undesired events. The potential benefits may include the effective removal of higher molecular weight uremic toxins and an improved nutritional status, along with a low inflammatory state.
AuthorsKhajohn Tiranathanagul, Kearkiat Praditpornsilpa, Pisut Katavetin, Nattachai Srisawat, Natavudh Townamchai, Paweena Susantitaphong, Kriang Tungsanga, Somchai Eiam-Ong
JournalTherapeutic apheresis and dialysis : official peer-reviewed journal of the International Society for Apheresis, the Japanese Society for Apheresis, the Japanese Society for Dialysis Therapy (Ther Apher Dial) Vol. 13 Issue 1 Pg. 56-62 (Feb 2009) ISSN: 1744-9987 [Electronic] Australia
PMID19379171 (Publication Type: Comparative Study, Journal Article)
Chemical References
  • Serum Albumin
  • beta 2-Microglobulin
  • Urea
  • C-Reactive Protein
Topics
  • Adult
  • Aged
  • Asia, Southeastern
  • Body Mass Index
  • C-Reactive Protein (metabolism)
  • Female
  • Follow-Up Studies
  • Hemodiafiltration (methods)
  • Humans
  • Kidney Failure, Chronic (therapy)
  • Male
  • Middle Aged
  • Nutritional Status
  • Prospective Studies
  • Serum Albumin (metabolism)
  • Treatment Outcome
  • Urea (metabolism)
  • beta 2-Microglobulin (blood)

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