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Daily hemofiltration with a simplified method of delivery
Deborah L Zimmerman1, Peter J Swedko, Gerald A Posen
1Department of Medicine, Division of Nephrology, Kidney Research Centre, University of Ottawa, Ottawa, ON, Canada.
ASAIO Journal (American Society for Artificial Internal Organs : 1992)
|August 16, 2003
Summary
Daily home hemodialysis (HD) and hemofiltration (HF) show promise for end-stage renal disease patients. This study found daily HF safe and effective, improving quality of life and reducing blood pressure.
Area of Science:
- Nephrology
- Renal Replacement Therapy
Background:
- Observational studies suggest daily hemodialysis (HD) and intermittent hemofiltration (HF) improve outcomes in end-stage renal disease (ESRD).
- A simplified HF system offers potential for home-based therapy.
Purpose of the Study:
- To evaluate the feasibility of daily HF as an alternative to intermittent HD.
- To assess changes in quality of life, nutrition, and laboratory values with daily HF.
Main Methods:
- Prospective study involving 7 ESRD patients.
- Patients underwent 1 week of intermittent HD followed by 4 weeks of daily HF using the NxStage system.
- Hemosol LG2/L0 was used as the replacement solution.
Main Results:
- Daily HF treatment time was 132 minutes, 6 days/week, compared to 232 minutes, 3 days/week for HD.
- Despite lower urea clearance (Kt/V) with HF, key parameters like potassium, calcium, phosphate, and nutrition remained stable.
- Kidney Disease Quality of Life Instrument Short Form (KDQOL-SF) scores improved or remained stable.
- Blood pressure decreased, allowing for reduced antihypertensive medication.
Conclusions:
- Daily HF using the simplified system is safe, simple, and efficacious.
- Preliminary data suggest daily HF is a viable home-based renal replacement therapy option.