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Related Experiment Videos

Dialysis efficacy during acetate-free biofiltration

A M Schrander-vd Meer1, P M ter Wee, A J Donker

  • 1Kennemer Gasthuis, Haarlem, The Netherlands.

Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association
|March 24, 1998
PubMed
Summary

Acetate-free biofiltration (AFB) improved dialysis efficacy (KT/V) and corrected acidosis without oral bicarbonate. However, parathyroid hormone (PTH) levels increased in AFB patients, requiring further investigation.

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Area of Science:

  • Nephrology
  • Biochemistry
  • Medical Technology

Background:

  • Acetate-free biofiltration (AFB) is a haemodiafiltration technique using bicarbonate solution.
  • Bicarbonate haemodialysis (HD) is a standard treatment for kidney failure.

Purpose of the Study:

  • To compare the long-term dialysis efficacy and metabolic control of AFB versus bicarbonate HD.
  • To evaluate the impact of AFB on biochemical parameters and dialysis adequacy.

Main Methods:

  • A randomized prospective trial comparing AFB (n=11) and HD (n=9) groups.
  • Biochemical parameters (hemoglobin, calcium, phosphate, urea, bicarbonate, PTH) monitored for 1 year.
  • Dialysis efficacy measured by KT/V using dialysate sampling; bicarbonate levels adjusted to target ranges.

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Main Results:

  • Both groups showed improved pre-dialysis bicarbonate levels; AFB had higher post-dialysis levels.
  • Calcium and phosphate remained stable; PTH increased in both groups, significantly in AFB.
  • KT/V increased in AFB patients (2.73 to 3.17) but not in HD patients, showing a significant difference between groups.

Conclusions:

  • AFB effectively corrects acidosis without oral bicarbonate supplementation.
  • Dialysis efficacy (KT/V) improved with AFB.
  • The increase in PTH in AFB patients requires further research; no changes in calcium or phosphate were observed.