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[Removal of small molecular proteins by push/pull HDF and alleviation of shoulder joint pain]
1Department of Internal Medicine, Branch Hospital, Nagoya University, School of Medicine.
Abstract:
The purpose of the present study was to compare hemodialysis (HD) and push/pull HDF in terms of uremic substance removal and clinical improvement. The treatment of patients complaining of shoulder joint pain was changed from conventional HD to HD or push/pull HDF using a hemodiafilter with large membrane pores. Push/pull HDF showed significantly greater removal of beta 2-microglobulin (beta 2-m) and other small molecular proteins than HD, and serum beta 2-m was significantly lower in concentration with push/pull HDF than HD. There was a decrease in the shoulder joint pain from push/pull HDF, and the range of upper arm movement thereby increased. However, neither this decrease in pain nor the increase in upper arm movement resulted with HD treatment. Hence, it was concluded that push/pull HDF is a more effective form of therapy.