Multifactorial evaluation of hemofiltration therapy in comparison with conventional hemodialysis

In order to ascertain if the potential benefits claimed for hemofiltration (HF) are supportable, chronic thrice-weekly HF therapy has been assessed in a group of nine uremic patients who had previously been stabilized on conventional hemodialysis (HD) for a mean of 17.8 months at a frequency of 3 x 5 hours/week. Changes between the termination of HD (= initiation of HF) and the last three months were observed in multifactorial parameters. No significant differences were observed in any parameter except the frequency of hypotensive episodes and the pretreatment levels of conventional waste metabolites. The latter were higher on HF than HD and the frequency of hypotension, 2% in HF, was less than the 8% frequency observed in HD, despite much larger body weight reductions per HF treatment. Also, the effects of HF on hypertension and hyperlipidemia were not significantly better than observed on HD therapy. Our preliminary conclusions are that HF is superior to HD in both the ease and safety of fluid removal and there is virtual elimination of the disequilibrium syndrome. However, HF offers no other obvious advantages over conventional hemodialysis therapy.