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[Comparison of two hours' biofiltration and four hours' bicarbonate hemodialysis by multiple clinical parameters]
1Tokyo Metropolitan Tama Geriatric Hospital, Japan.
Abstract:
Ten uremic patients maintained stable on regular dialysis treatment participated in a comparison study of 2 hours' biofiltration and 4 hours' bicarbonate hemodialysis with informed consents. In biofiltration, ultrafiltrate was replaced by a solution consisting of Na 145 mEq/l, HCO3- 100 and Cl 45 at the infusion rate 2.51/hour. Dialysate composition was Na 130-149 mEq/l, K 1.0, Cl 119, Ca 2.5, Mg 0.5, CH3COO- 15 and glucose 200 mg/dl. Hemodiafilter was F80, polysulphone, 1.9 m2, manufactured by Fresenius Co. Ltd. Blood flow rate was 5 ml/min/kg.body.weight to keep urea index (Kt/V) over 1.0. B-A-B' comparison was designed in which B and B' stand for 4 hours' bicarbonate hemodialysis while A for 2 hours' biofiltration, 3 times per week for 2 months, respectively. It was intended to find out if there are aggravations of clinical parameters in A after B and/or improvements in B' after A in view of evaluation of optimum for 2 hours' biofiltration. One patient was withdrawn from biofiltration at 15th treatment in A because of frequent muscular twitchings. Others finished the whole program, thus making drop-out rate 10%. No significant differences were observed in the following parameters between B and A and between A and B': cardiothoratic ratio, pre-treatment blood pressure, human atrial natriuretic hormone, cardiovascular dynamics, total protein, BUN, serum creatinine, uric acid, beta 2 microglobulin, blood counts, blood gas analysis, electrolytes, alkaline-phosphatase, PTH-C, protein catabolic rate (PCR), lipids and liver functions.(ABSTRACT TRUNCATED AT 250 WORDS)