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Paediatric experience with acetate-free biofiltration
M Espino Hernandez1, D Morales San Jose, A Luque de Pablos
1Paediatric Nephrology Unit, Hospital Gregorio Marañon, University of Madrid, Spain.
Pediatric Nephrology (Berlin, Germany)
|June 1, 1995
Summary
Acetate-free biofiltration in children achieved adequate hemodialysis (HD) with no adverse events. This modified hemodiafiltration successfully corrected acidosis without hypertension or cramps.
Area of Science:
- Nephrology
- Pediatric Dialysis
- Renal Replacement Therapy
Background:
- Traditional hemodialysis (HD) can lead to acid-base disturbances.
- Buffer in dialysate can cause adverse effects in some patients.
- Acetate-free biofiltration offers an alternative approach to fluid and electrolyte management during HD.
Purpose of the Study:
- To evaluate the preliminary experience of acetate-free biofiltration in pediatric patients.
- To assess the efficacy and safety of this modified hemodiafiltration technique.
- To determine the adequacy of dialysis and acid-base correction.
Main Methods:
- Five pediatric patients underwent acetate-free biofiltration, a modification of hemodiafiltration.
- Bicarbonate was infused simultaneously through a venous port without buffer in the dialysate.
- Dialysis adequacy was assessed using Kt/v and protein catabolic rate (PCR).
Main Results:
- Adequate hemodialysis (HD) was achieved with 3-hour treatments thrice weekly (mean Kt/v 1.35 ± 0.29).
- Mean protein catabolic rate (PCR) was 1.4 ± 0.3 mg/dL, indicating sufficient protein metabolism.
- No hypertension, cramps, hypotension, or vomiting occurred; pH increased from 7.4 to 7.5 post-HD.
Conclusions:
- Acetate-free biofiltration is a safe and effective method for achieving adequate dialysis in children.
- This technique successfully corrects acidosis without adverse cardiovascular or gastrointestinal events.
- Bicarbonate requirements were correlated with dialyzer surface area and body weight.