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Vascular stability and middle molecules removal in hypertonic haemodiafiltration
Proceedings of the European Dialysis and Transplant Association. European Dialysis and Transplant Association
|January 1, 1981
Summary
Hypertonic haemodiafiltration effectively reduces myeloma cells and small molecules during dialysis. This method achieved significant solute removal without impacting vascular stability in patients undergoing treatment.
Area of Science:
- Nephrology
- Oncology
- Biomedical Engineering
Background:
- Multiple myeloma (MM) treatment often involves dialysis.
- Optimizing dialysis efficiency for solute and MM removal is crucial.
- Vascular stability during dialysis is a key patient consideration.
Purpose of the Study:
- To evaluate the efficacy of a novel hypertonic haemodiafiltration (HHD) protocol.
- To assess the impact of HHD on multiple myeloma (MM) cell reduction.
- To determine the effect of HHD on small molecule clearance and vascular stability.
Main Methods:
- Simultaneous hypertonic haemofiltration (delta 550, Na 275mEq/L) and hypotonic haemodialysis (delta 282).
- Low volume (7.2 litres) treatment for a short duration (180 minutes).
- Three hours, thrice-weekly dialysis program.
Main Results:
- Significant reduction in predialysis multiple myeloma (MM) cell pool (-48%).
- Substantial decrease in small molecule levels (-33%).
- Achieved a net ultrafiltration (UF) of 20.5 ml/min with enhanced solute removal up to 1500 daltons.
Conclusions:
- Hypertonic haemodiafiltration is effective in reducing both MM cells and small molecules.
- The protocol demonstrated efficient solute removal without compromising vascular stability.
- HHD offers a promising therapeutic option for multiple myeloma patients requiring dialysis.