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Expanded home hemodialysis: case reports.
Alejandro Pérez-Alba1,2, Javier Reque-Santiváñez3, Milagros Vázquez-Gómez3
1Department of Nephrology, Hospital Universitari General de Castellón, Avinguda de Benicàssim, 128, 12004, Castellón de la Plana, Spain. aperezalba@gmail.com.
International Urology and Nephrology
|April 17, 2020
Summary
Short daily home hemodialysis (HD) offers benefits. Expanded hemodialysis at home (HHDx) using specific membranes significantly reduced β2-microglobulin levels, showing a safe and effective alternative for patients.
Area of Science:
- Nephrology
- Renal Replacement Therapy
Background:
- Short daily hemodialysis at home (SDHHD) offers clinical advantages.
- Expanded hemodialysis (HDx) utilizes high-cutoff membranes for enhanced clearance of medium-to-high molecular weight uremic toxins.
Purpose of the Study:
- To evaluate the clinical outcomes and safety of expanded hemodialysis at home (HHDx).
- To assess the efficacy of HHDx in managing uremic toxin levels and medication use.
Main Methods:
- A case series of seven patients transitioned to HHDx from December 2017 to March 2019.
- Utilized the AK-98 monitor and Theranova 400 membrane over a 12-month follow-up.
- Monitored blood analytical values and drug consumption as primary outcomes.
Main Results:
- Significant reduction in blood β2-microglobulin levels (p=0.0082).
- Albumin levels were maintained.
- Reduced need for phosphorus binders.
- No technique-related adverse events were reported, indicating a favorable safety profile.
Conclusions:
- Home expanded hemodialysis (HHDx) is a safe and effective technique.
- HHDx offers enhanced purification capacity, providing clinical benefits to patients.
- Further multicenter studies with larger cohorts are recommended to validate these findings.
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