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Short-time hemodiafiltration using polymethylmethacrylate hemodiafilter
Transactions - American Society for Artificial Internal Organs
|January 1, 1978
Summary
Short-term hemodiafiltration (HDF) effectively removed fluid and middle molecules in four patients, proving well-tolerated. This hemodialysis and hemofiltration combination offers a promising treatment for uremic patients.
Area of Science:
- Nephrology
- Biomedical Engineering
Background:
- Uremic patients require efficient removal of small and middle molecules.
- Conventional hemodialysis (HD) has limitations in clearing larger solutes.
- Hemodiafiltration (HDF) offers simultaneous hemofiltration and dialysis.
Purpose of the Study:
- To evaluate the efficacy and tolerance of short-time hemodiafiltration (HDF).
- To compare the molecule removal rate of HDF with conventional HD.
- To assess the impact of HDF on patient stability and biochemical parameters.
Main Methods:
- Four patients underwent thrice-weekly 3-hour HDF sessions using Toray HDF system and polymethylmethacrylate filters.
- Fluid removal averaged 9-10 L with 7-8 L post-dilution substitution fluid reinfusion.
- Chromatographic analysis was used to measure molecule reduction rates.
Main Results:
- HDF was well-accepted with stable blood pressure and negligible disequilibrium syndrome.
- Middle to larger molecule reduction was 20-100% higher than conventional HD.
- Acidosis, lactate, and acetate levels were effectively corrected; amino acid loss was minimal (3 gm/treatment).
Conclusions:
- Short-time HDF demonstrates superior middle molecule clearance compared to conventional HD.
- HDF is a safe and effective treatment option for uremic patients.
- The simultaneous removal of small and middle molecules makes HDF a treatment of choice for uremia.