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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
PubMed
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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.

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  • 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.