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Online hemodiafiltration versus acetate-free biofiltration: a prospective crossover study
Feng Ding1, Peter Ahrenholz, Roland E Winkler
1BioArtProducts GmbH, Rostock, Germany.
Artificial Organs
|March 7, 2002
Summary
Online hemodiafiltration (online HDF) and acetate-free biofiltration (AFB) offer advanced kidney replacement therapy. Online HDF provides superior toxin clearance and fewer symptoms, while AFB ensures better hemodynamic stability and blood gas balance.
Area of Science:
- Nephrology
- Renal Replacement Therapy
- Biomedical Engineering
Background:
- Online hemodiafiltration (online HDF) and acetate-free biofiltration (AFB) are advanced renal replacement therapies.
- Both methods demonstrate advantages over conventional hemodialysis.
Purpose of the Study:
- To compare the efficacy and safety of online HDF (predilution and postdilution) and AFB in stable maintenance hemodialysis patients.
Main Methods:
- A prospective, randomized crossover trial involving 12 stable hemodialysis patients.
- Patients were treated with AFB, pre-HDF, and post-HDF for 36 weeks using F60S high-flux dialyzers.
- Evaluated parameters included biochemical tests, bone metabolism, substance clearance, intradialysis symptoms, and hemodynamic stability.
Main Results:
- Both online HDF and AFB were well-tolerated.
- Online HDF showed higher delivered dialysis dose (Kt/V) and clearance of urea and beta2-microglobulin (beta2-M), with fewer interdialysis symptoms.
- AFB demonstrated better intradialysis hemodynamic tolerance and less impact on arterial blood gases, though associated with potential complications possibly due to low dialysate calcium.
Conclusions:
- Both online HDF and AFB represent optimal renal replacement therapies.
- Online HDF excels in toxin removal and symptom management.
- AFB offers improved hemodynamic stability and blood gas balance during dialysis.