Preferred dialysis fluid for the high-performance membrane

In the present study, we investigated the effect of hemodialysis (HD) with high-performance membrane filter (HPM-HD) using acetate-free bicarbonate dialysis (AFD) fluid on bioincompatibility as represented by inflammatory markers in patients undergoing maintenance HD therapy and compared it with conventional acetate-containing bicarbonate dialysis (ACD) fluid. A total of 36 maintenance HD patients were registered for study during the 4-month study period (22 males and 14 females, aged 63.5 ± 10.2 years, mean duration of dialysis 12.2 ± 8.6 years, chronic glomerular nephritis in 27 patients, diabetic nephropathy in 6 patients, and nephrosclerosis in 3 patients). These patients were subjected to ACD for the first 2 months followed by AFD fluid for the latter 2 months. Predialysis blood pH and bicarbonate were examined after each of the first and latter 2-month period. Blood variables of C-reactive protein (CRP) and interleukin-6 (IL-6) or fetuin-A were also determined. The filters (membrane surface area, raw material), the conditions of HD (blood flow rate, dialysate flow rate, dialysis time, dry weight) and drug regimen including erythrocyte-simulating agent (drug type, dosage) were unchanged throughout the study. There appeared to be significantly higher levels of predialysis blood pH and bicarbonate in the AFD phase than in the ACD phase. Blood CRP and IL-6 levels were significantly decreased in the AFD group as compared with those seen in the ACD group. From these results, it can be suggested that HPM-HD using AFD fluid contributes to correcting metabolic acidosis and alleviating microinflammation in HD patients.