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Variation of clinical and laboratory features in chronic dialysis patients treated with high-flux hemodialysis after switching to online hemodiafiltration

  • Nephrology - Original Paper
  • Published:
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Abstract

Purpose

The study of online hemodiafiltration (HDF) benefits over high-flux hemodialysis (HD) raises great interest. The purpose was to compare clinical and laboratory parameters in patients treated with HD who were switched to HDF.

Methods

Forty-eight HD patients (study group) were switched to HDF, while other 521 patients remained on HD as a control group. During last 6 HD months and during first year of HDF, we determined in both groups the following parameters: monthly–weekly dialysis time, systolic and diastolic blood pressure, body mass index (BMI), interdialytic body weight gain (IBWG), blood flow rate (Qb), weekly erythropoietin-stimulating agents dose (EPO), single-pool Kt/V, calcium, phosphorus (P), hemoglobin and normalized protein catabolic ration (nPCR), plus every 3 months—albumin, parathormone (PTH), ferritin and transferrin saturation (TSAT). In both groups, parameters in the last 6 HD months were compared to those in the first 6 months and, respectively, to those in the first year of HDF.

Results

In the study group, albumin and nPCR were significantly higher in the HD period not only compared to the first 6 months of HDF, but also compared to the first year of HDF. IBWG and P were higher with HD compared to the first year of HDF, but not with the first 6 months. PTH, Kt/V, Qb and EPO were higher in both HDF periods. In the control group, albumin was significantly higher in the first 6 months after the switch, but it was significantly lower in the first year. BMI, ferritin, PTH, Kt/V, Qb, TSAT and weekly dialysis time were higher in both HDF periods, while nPCR, EPO, SBP and DBP were lower. IBWG and Hb rose only during the first year after the switch, while P was lower in the first year, but not in the first 6 months.

Conclusions

Nutrition, assessed by albumin, nPCR and BMI, was not improved by HDF compared to HD. With HDF, Kt/V and phosphorus control were better, similar results were observed in the control group. A larger EPO dose was needed with HDF for maintaining a similar hemoglobin level.

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Conflict of interest

The authors declare that they have no conflict of interest.

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Authors and Affiliations

  1. Nefromed Dialysis Centers, Cluj-Napoca, Romania

    Remus Aurel Orasan & Ioan Mihai Patiu

  2. Nefromed Dialysis Centers, Alba, Romania

    Daniela Anghel

  3. Nefromed Dialysis Centers, Barlad, Romania

    Cezarina Bejan

  4. Nefromed Dialysis Centers, Botosani, Romania

    Ligia Iosub

  5. Nefromed, Timisoara, Romania

    Camelia Totolici

  6. Nefromed Dialysis Centers, Baia-Mare, Romania

    Mariana Pop

  7. Nefromed Dialysis Centers, Piatra Neamt, Romania

    Carmen Turcea

  8. Nefromed Dialysis Centers, Sibiu, Romania

    Cristina Teodoru

  9. 4th Department of Internal Medicine, University of Medicine and Pharmacy “Iuliu Hatieganu”, Cluj-Napoca, Romania

    Olga Hilda Orasan

  10. Department of Nephrology, University of Medicine and Pharmacy “Iuliu Hatieganu”, Cluj-Napoca, Romania

    Ina Maria Kacso & Mirela Gherman Caprioara

Authors
  1. Remus Aurel Orasan
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  2. Ioan Mihai Patiu
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  3. Daniela Anghel
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  4. Cezarina Bejan
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  7. Mariana Pop
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  8. Carmen Turcea
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  9. Cristina Teodoru
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  10. Olga Hilda Orasan
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  12. Mirela Gherman Caprioara
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Correspondence to Remus Aurel Orasan.

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Orasan, R.A., Patiu, I.M., Anghel, D. et al. Variation of clinical and laboratory features in chronic dialysis patients treated with high-flux hemodialysis after switching to online hemodiafiltration. Int Urol Nephrol 45, 1415–1422 (2013). https://doi.org/10.1007/s11255-012-0341-7

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  • DOI: https://doi.org/10.1007/s11255-012-0341-7

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