Related Experiment Video
Updated: May 12, 2025
Continuous Manual Exchange Transfusion for Patients with Sickle Cell Disease: An Efficient Method to Avoid Iron Overload
Published on: March 14, 2017
Uremic toxins removal and iron status: a medium-term comparison between 4 dialysis techniques (EMPIRE study)
Marianna Napoli1,2, Gaetano Alfano3, Anna Scrivo1,2
1Nephrology, Dialysis and Kidney Transplant Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy.
Background:
Recent evidence documented that dialyzers and hemodialytic techniques yield different dialytic performances. The study aims to compare uremic toxins removal and iron status between on-line hemodiafiltration (OL-HDF), high-flux hemodialysis (HF-HD), expanded hemodialysis (HDx), and HFR Aequilibrium (HFR-Aeq).
Methods:
A single-center retrospective observational study enrolled 52 patients on chronic HD. Each study group (HFR-Aeq, HDx, HF-HD, and OL-HDF) included 13 patients. Naïve patients for each of the treatments were considered. Serum samples were collected at baseline and after 12-24-48 weeks from the enrollment. Intragroup comparison was performed using Friedman's test whereas longitudinal data were compared using linear mixed models (LMMs).
Results:
HDx showed a progressive improvement in the removal of urea (p = 0.043), λ -free light chains (p = 0.033), and transferrin saturation (p = 0.011) compared to other techniques. A nearly significant slope of β2 M was observed (p = 0.066). Also HFR-Aeq showed a near significant reduction in λ FLC values (p = 0.05) and a nearly significant increase in albumin levels (p = 0.07).
Conclusions:
HFR-Aeq provides uremic toxins removal comparable to other traditional techniques (HF-HD, OL-HDF). HDx confirmed its superiority in the removal of uremic toxins as urea and λ FLC and surprisingly enhanced TSAT by a possible anti-inflammatory effect not ascertained in the present study. The utilization of non-optimal convective volumes likely vanishes the promising findings of OL-HDF.
More Related Videos
07:11Surgical Techniques for Catheter Placement and 5/6 Nephrectomy in Murine Models of Peritoneal Dialysis
Published on: July 19, 2018
09:23Removal of Trace Elements by Cupric Oxide Nanoparticles from Uranium In Situ Recovery Bleed Water and Its Effect on Cell Viability
Published on: June 21, 2015
Related Concept Videos
01:27Dialysis
Acute kidney injury develops suddenly and can be caused by pre-renal causes (e.g., hypovolemia, shock), intrinsic renal causes (e.g., acute tubular necrosis), or post-renal causes (e.g., urinary obstruction). In contrast, chronic renal failure progresses gradually over time and is often...
01:17Factors Affecting Renal Clearance: Renal Impairment
One condition associated with renal failure is uremia. Uremia is characterized by impaired glomerular filtration and fluid accumulation in the body. This condition hinders the renal clearance of drugs, resulting in drug accumulation and potential...
01:11Renal Failure: Dose Adjustments
Reduced renal clearance and elimination rate are common outcomes of renal impairment. These alterations lead to a prolonged elimination half-life and an altered apparent volume of distribution for drugs. As a result, dosage adjustments are typically necessary to maintain optimal drug levels in the body.
However, dosage adjustments...
01:18Effects of EDTA on End-Point Detection Methods
In the visual method, metal-ion indicators (metallochromic dyes), which have distinct colors in their free and complex forms, are added to the mixture to signal the titration's end point. They form stable complexes with metal ions, but these complexes are weaker than the corresponding metal–EDTA complexes. As a...
01:08Renal Drug Clearance: Comparison Between Renal Excretion Methods
Renal clearance is often associated with the renal glomerular filtration rate (GFR), which represents the rate at which plasma is filtered through the glomeruli in the kidney. When drug reabsorption is minimal and there is no active secretion, renal clearance is closely related to the...