ON-LINE HEMODIAFILTRATION AND PHOSPHATE REMOVAL IN END STAGE RENAL DISEASE PATIENTS ON HEMODIALYSIS
https://doi.org/10.24884/1561-6274-2013-17-1-70-72
Abstract
THE AIM. The control of hyperphosphatemia by calcium- or aluminium- containing phosphate-binders leads to other complications like hypocalcemia, soft tissue/vascular calcifications, calciphylaxis. The application of non-calcium- non-alluminium-containing phosphate-binders and calcimimetics is very expensive. The aim of the study was to compare phosphate removal during preand post-dilutional on-line hemodiafiltration (HDF) as well as to compare phosphate removal during HDF with different volume of substitutional solution. PATIENTS AND METHODS. 13 end stage renal disease patients (ESRDP) were included in the study. 49 HDF were realized – 41 with substitution of 8600 ml and 8 – with 12000 ml (HDF-8600 and HDF-12000). Phosphate-Kt/v (Daugirdas 2nd generation) and phosphate-Reduction Ratio (RR; %) were calculated. RESULTS. Phosphate removal according to Kt/v during pre-dilutional and post-dilutional HDF-8600 was similar: 0.915±0.304 (n=24) and 0.908±0.234 (n=17) respectively, P=NS. Phosphate RR (%) achieved by mentioned modalities of HDF 8600 was 52.02±12.28 (n=24) and 51.900±10.810 (n=17), P=NS. During post-dilutional HDF-12000, phosphate removal was lower than that during post-dilutional HDF-8600: Kt/ v=0.689±0.009 (n=8) versus 0.908±0.234 (n=17), P<0.001 and RR=43.62±5.870 (n=8) versus 51.900±10.810 (n=17), P<0.01, respectively. CONCLUSION. (1).There is no difference between phosphate removal during pre- and post-dilutional HDF-8600 according to Kt/v. (2). Phosphate removal is more effective in HDF-8600 compared to HDF-12000 ml according to Kt/v and RR.
About the Authors
R. Y. Zortcheva
Клиника нефрологии и диализа, Медицинский университет Варны
Bulgaria
Bulgaria
V. Ch. Ikonomov
Клиника нефрологии и диализа, Медицинский университет Варны
Bulgaria
Bulgaria
D. N. Paskalev
Клиника нефрологии и диализа, Медицинский университет Варны
Bulgaria
Bulgaria
References
1. Block GA, Klassen PS, Lazarus JM, Ofsthun N, Lowrie EG, Chertow GM. Mineral metabolism, mortality and morbidity in maintenance hemodialysis. J Am Soc Nephrol 2004; 15, 2208-2218
2. Block GA, Hulbert-Shearon TE, Levin NW, Port FK. Association of serum phosphorus and Ca×P product with mortality risk in chronic hemodialysis patients: A national study, Am J Kidney Dis 1998; 31(4): 607-617
3. Young EW, Albert JM, Satayathum S et al. Predictors and consequences of altered mineral metabolism: the Dialysis Outcomes and Practice Patterns Study. Kidney Int 2005; 67; 1179-1187
4. Ketteler M, The control of hyperphosphatemia in chronic kidney disease: Which phosphate binder? Int J Artif Organs 2009; 32: 95-105
5. Block GA, Port FK, Re-evaluation of risk associated with hyperphosphatemia and hyperparathyroidism in dialysis patients: recommendations for a change in management. Am J Kidney Dis 2000; 35(6):1226-1237
6. Chertow GM, Burke SK, Raggi P; Treat to Goal Working Group, Sevelamer attenuates the progression of coronary and aortic calcification in hemodialysis patients. Kidney Int 2002; 62: 245-252
7. Kambova L, Ionova D, Kirijakov Z, Aluminium overload influences cognitive function in patients on dialysis. J Nephrol Dialysis & Transplant 1994; l 9 (9): 1357
8. Locatelli F, Manzoni C, Vigano S et al. Hemodiafiltration – state of the art, In: Kawanishi H, Yamashita AC, eds, Hemodiafiltration – A new era. Contrib Nephrol Karger, Basel, 2011, Vol 168; 5-18
9. Wizemann V, Lotz C, Techert F, Uthoff S. On-line haemodiafiltration versus low-flux haemodialysis, A prospective randomized study. Nephrol Dial Transplant 2000; 15 [suppl 1]: 43-48
10. Zehnder C, Gutzwiller JP, Renggli K, Hemodiafiltration – a new treatment option for hyperphosphatemia in hemodialysis patients. Clin Nephrol 1999; 52: 152-159
11. Minutolo R, Bellizzi V, Cioffi M et al. Postdialytic rebound of serum phosphorus: pathogenetic and clinical insights. J Am Soc Nephrol 2002; 13:1046-1054
12. Lornoy W, De Meester J, Because I et al, Impact of convective flow on phosphorus removal in maintenance on hemodialysis patients. J Ren Nutr 2006; 16: 47-53
13. Schiffl H, Prospective randomized cross-over long-term comparison of online haemodiafiltration and ultrapure high-flux haemodialysis. Eur J Med Res 2007; 12: 26-33
Review
For citations:
Zortcheva R.Y., Ikonomov V.Ch., Paskalev D.N. ON-LINE HEMODIAFILTRATION AND PHOSPHATE REMOVAL IN END STAGE RENAL DISEASE PATIENTS ON HEMODIALYSIS. Nephrology (Saint-Petersburg). 2013;17(1):70-72. (In Russ.) https://doi.org/10.24884/1561-6274-2013-17-1-70-72
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