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Phosphorus Clearance Using Two Hemodialyzers Placed in Parallel.

Mitchell H Rosner1,2, Allen Helmandollar1, Ryan Evans1

  • 1Division of Nephrology, University of Virginia Health Sciences Center, Charlottesville, Virginia, U.S.A.

Hemodialysis International. International Symposium on Home Hemodialysis
|April 30, 2017
PubMed
Summary
This summary is machine-generated.

Using two dialyzers in parallel significantly improves phosphate removal in hemodialysis patients. This method enhances phosphorus clearance and total removal, potentially by increasing the concentration gradient for phosphorus transfer.

Keywords:
Phosphorusclearanceskineticsparallel dialyzers

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Area of Science:

  • Nephrology
  • Renal Replacement Therapy
  • Dialysis Technology

Background:

  • Hyperphosphatemia is a critical issue in end-stage renal disease patients.
  • Inefficient inorganic phosphorus removal during hemodialysis presents a significant clinical challenge.

Purpose of the Study:

  • To compare phosphate and urea clearances and total phosphorus removal between single and parallel dialyzer configurations.
  • To investigate the impact of parallel dialyzers on hemodialysis efficiency for phosphorus management.

Main Methods:

  • A comparative study involving patients with end-stage renal disease undergoing hemodialysis.
  • Utilized two F-80 dialyzers in parallel (DD group) versus a single F-80 dialyzer (SD group).
  • Measured clearances via total dialysate collections, maintaining identical blood flow, dialysate flow, and treatment times.

Main Results:

  • The parallel dialyzer group (DD) showed significantly higher absolute phosphorus removal (1594 ± 300 mg) compared to the single dialyzer group (SD) (1108 ± 285 mg; p=0.03).
  • Phosphorus clearance was significantly greater in the DD group (178 ± 32 mL/min) versus the SD group (149 ± 38 mL/min; p=0.039).
  • While Kt/V urea was similar (p=0.2), urea clearance trended higher in the DD group (285 ± 25 mL/min) vs. SD group (251 ± 27 mL/min; p=0.082).

Conclusions:

  • Employing hemodialyzers in parallel enhances both phosphate clearance and total phosphorus removal during hemodialysis.
  • Increased phosphate removal in parallel configurations may be attributed to an augmented concentration gradient facilitating transfer from a second body phosphorus compartment.
  • The majority of phosphorus removal occurs within the initial two hours of hemodialysis, supporting a multi-compartment body phosphorus model.