Skip to main content
Log in

Comparison of the effects of predilution and postdilution hemodiafiltration on neutrophils, lymphocytes and platelets

  • Original Article
  • Published:
Journal of Artificial Organs Aims and scope Submit manuscript

Abstract

Numerous studies have been carried out to investigate the solute removal efficiency of hemodiafiltration (HDF). However, the effect of the dilution mode on blood cell damage during HDF has not yet been examined in detail. Here, we compared predilution and postdilution HDF with respect to their effects on blood cells. Five patients were allocated to one session each of predilution HDF and postdilution HDF. Concentrations of interleukin (IL)-6, intercellular adhesion molecule (ICAM)-1, and platelet-derived microparticles (PDMP), and the phagocytotic and sterilizing functions of neutrophils before and after the HDF sessions were evaluated. Lymphocyte blastoid transformation induced by mitogens was also evaluated by measurement of the [3H]-thymidine uptake. The IL-6 and ICAM-1 concentrations decreased after predilution HDF, and increased after postdilution HDF. Lymphocyte blastoid transformation was more pronounced after predilution HDF than after postdilution HDF. There was no significant difference in PDMP between the dilution modes. We conclude that predilution HDF could be more favorable for dialysis patients than postdilution HDF from the point of view of the effects on the blood cells, especially neutrophils and lymphocytes.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5
Fig. 6

Similar content being viewed by others

References

  1. Arenholz P, Winkler RE, Ramlow W, Tiess W, Müller W. On-line hemodiafiltration with pre- and postdilution: a comparison of efficacy. Int J Artif Organs. 1997;20:81–90.

    Google Scholar 

  2. Arenholz P, Winkler RE, Michelsen A, Land DA, Bowry SK. Dialysis membrane-dependent removal of middle molecules during hemodiafiltration: the beta-microglobulin/albumin relationship. Clin Nephrol. 2004;62:21–8.

    Article  Google Scholar 

  3. Lornoy W, Becaus I, Billiouw JM, Sierens L, Van Malderen P, D’Haenens P. On-line haemodiafiltration. Remarkable removal of beta2-microglobulin. Long-term clinical observations. Nephrol Dial Transp. 2000;15:49–54.

    Article  Google Scholar 

  4. Pedrini LA, De Cristofaro V, Pagliari B, Samà F. Mixed predilution and postdilution online hemodiafiltration compared with the traditional infusion modes. Kidney Int. 2000;58:2155–65.

    Article  PubMed  CAS  Google Scholar 

  5. Pedrini LA, De Cristofaro V. On-line mixed hemodiafiltration with a feedback for ultrafiltration control: effect on middle-molecule removal. Kidney Int. 2003;64:1505–13.

    Article  PubMed  Google Scholar 

  6. Canaud B, Levesque R, Krieter D, Desmeules S, Chaiabi L, Moraguēs H, Morena M, Cristol JP. On-line hemodiafiltration as routine treatment of end-stage renal failure: why pre- or mixed dilution mode is necessary in on-line hemodiafiltration today? Blood Purif. 2004;22:40–8.

    Article  PubMed  Google Scholar 

  7. Feliciani A, Rive MA, Zerbi S, Ruggiero P, Cozzi G, Pedrini LA. New strategies in haemodiafiltration (HDF): prospective comparative analysis between on-line mixed HDF and mid-dilution HDF. Nephrol Dial Transp. 2007;22:1672–9.

    Article  CAS  Google Scholar 

  8. Maduell F, Arias M, Vera M, Fontserē N, Blasco M, Barros X, Garro J, Elena M, Bergada E, Cases A, Bedini JL, Compistol JM. Mid-dilution hemodiafiltration: a comparison with pre- and postdilution modes using the same polyphenylene membrane. Blood Purif. 2009;28:268–74.

    Article  PubMed  CAS  Google Scholar 

  9. Meert N, Eloot S, Waterloos MA, Van Landschoot M, Dhondt A, Glorieux G, Ledebo I, Vanholder R. Effective removal of protein-bound uraemic solutes by different convective strategies: a prospective trial. Nephrol Dial Transp. 2009;24:62–570.

    Google Scholar 

  10. Canaud B, Bragg-Gresham JL, Marshal MR, Desmeules S, Gillespie BW, Depner T, Klassen P, Port FK. Mortality risk for patients receiving hemodiafiltration versus hemodialysis: European results from the DPPPS. Kidney Int. 2006;69:2087–93.

    Article  PubMed  CAS  Google Scholar 

  11. Panichi V, Rizza GM, Paoletti S, Paoletti S, Bigazzi R, Aloisi M, Barsotti G, Rindi P, Donati G, Antoneli A, Panicucci E, Tripepi G, Tetta C, Palla R. RISCAVID Study Group. Chronic inflammation and mortality in haemodialysis: effect of different renal replacement therapies. Results from the RISCAVID study. Nephrol Dial Transp. 2008;23:2337–43.

    Article  Google Scholar 

  12. Santoro A, Mancici E, Bolzani R, Boggi R, Cagnoli L, Francioso A, Fusaroli M, Piazza V, Rapanà R, Strippoli GF. The effectiveness of on-line high-flux hemofiltration versus low-flux hemodialysis on mortality in chronic kidney failure: a small randomized controlled trial. Am J Kidney Dis. 2008;52:507–17.

    Article  PubMed  CAS  Google Scholar 

  13. Vilar E, Fry AC, Wellsted D, Tattersall JE, Greenwood RN, Farrington K. Long-term outcomes in online hemodiafiltration and high-flux hemodialysis: a comparative analysis. Clin J Am Soc Nephrol. 2009;4:1944–53.

    Article  PubMed  CAS  Google Scholar 

  14. Locatelli F, Altieri P, Andrulli S, Bolasco P, Sau G, Pedrini LA, Basile C, David S, Feriani M, Montagna G, Di Iorio BR, Memoli B, Cravero R, Battaglia G, Zoccali C. Hemofiltration and hemodiafiltration reduce intradialytic hypotension in ESRD. J Am Soc Nephrol. 2010;21:1798–807.

    Article  PubMed  CAS  Google Scholar 

  15. Masakane I. Selection of dilutional method for on-line HDF, pre- or post-dilution. Blood Purif. 2004;22:49–54.

    Article  PubMed  CAS  Google Scholar 

  16. Savica V, Ciolino F, Monardo P, Mallamace A, Savica R, Santoro D, Bellinghieri G. Nutritional status in hemodialysis patients: options for on-line convective treatment. J Ren Nutr. 2006;16:237–40.

    Article  PubMed  Google Scholar 

  17. Oppenheim JJ, Schecter B. Lymphocyte transformation. In: Rose NR, Friedman H, editors. Manual of clinical immunology. 2nd ed. Washington, DC: American Society for Microbiology; 1980. p. 233–41.

    Google Scholar 

  18. Hasuike Y, Nonoguchi H, Ito K, Naka M, Kitamura R, Nanami M, Tokuyama M, Kida A, Otaki Y, Kuragano T, Nakanishi T. Interleukin-6 is a predictor of mortality in stable hemodialysis patients. Am J Nephrol. 2009;30:389–98.

    Article  PubMed  CAS  Google Scholar 

  19. Kaizu Y, Kimura M, Yoneyama T, Miyaji K, Hibi I, Kumagai H. Interleukin-6 may mediate malnutrition in chronic hemodialysis patients. Am J Kidney Dis. 1998;31:93–100.

    Article  PubMed  CAS  Google Scholar 

  20. Pecoits-Fiho R, Bárány P, Lindholm B, Heimbürger O, Stenvinkel P. Interleukin-6 is an independent predictor of mortality in patients starting dialysis treatment. Nephrol Dial Transp. 2002;17:1684–8.

    Article  Google Scholar 

  21. Beberashvili I, Sinuani I, Azar A, Yasur H, Shapiro G, Feldman L, Averbukh Z, Weissgarten J. IL-6 levels, nutritional status, and mortality in prevalent hemodialysis patients. Clin J Am Soc Nephrol. 2011;6:2253–63.

    Article  PubMed  CAS  Google Scholar 

  22. Papayianni A, Alexopoulos E, Giamalis P, Belechri AM, Koukoudis P, Memmos D. Circulating levels of ICAM-1, VCAM-1, and MCP-1 are increased in haemodialysis patients: association with inflammation, dyslipidaemia, and vascular events. Nephrol Dial Transp. 2002;17:435–41.

    Article  CAS  Google Scholar 

  23. Papagianni A, Dovas S, Bantis C, Belechri AM, Kalovoulos M, Dimitriadis C, Efstratiadis G, Alexopoulos E, Memmos D. Carotid atherosclerosis and endothelial cell adhesion molecules as predictors of long-term outcome in chronic hemodialysis patients. Am J Nephrol. 2008;28:265–74.

    Article  PubMed  CAS  Google Scholar 

  24. Filipoulos V, Hadjiyannakos D, Metaxaki P, Sideris V, Takouli L, Anogiati A, Vlassopoulos D. Inflammation and oxidative stress in patients on hemodiafiltration. Am J Nephrol. 2008;28:949–57.

    Article  Google Scholar 

  25. Nakamura M, Hosoya Y, Hirose D, Tao T, Suzuki K, Tsuchida K, Minakuchi J, Kawashima S. Effects of predilution HDF and postdilution HDF on proinflammatory cytokine production. Kidney Dial. 2007;64:103–7. (Japanese).

    Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding authors

Correspondence to Kenji Sakurai or Takeshi Saito.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Sakurai, K., Saito, T., Yamauchi, F. et al. Comparison of the effects of predilution and postdilution hemodiafiltration on neutrophils, lymphocytes and platelets. J Artif Organs 16, 316–321 (2013). https://doi.org/10.1007/s10047-013-0698-0

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10047-013-0698-0

Keywords

Navigation