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On-line hemodiafiltration with pre- and postdilution: impact on the acid-base status
P Ahrenholz1, R E Winkler, W Ramlow
1BioArtProducts GmbH, Rostock, Germany.
The International Journal of Artificial Organs
|August 26, 1998
Summary
High-flux hemodialysis (HD), postdilution hemodiafiltration (POD-HDF), and predilution HDF (PRD-HDF) showed no significant differences in acid-base status. All modes effectively corrected acidosis in end-stage renal disease patients without overcompensation.
Area of Science:
- Nephrology
- Biomedical Engineering
- Physiology
Background:
- On-line formation of substitution fluid in hemodiafiltration (HDF) allows high substitution rates in predilution (PRD) and postdilution (POD) modes.
- Understanding the impact of different HDF treatment modes on acid-base balance is crucial for optimizing patient care.
Purpose of the Study:
- To compare the effects of high-flux hemodialysis (HD), POD-HDF, and PRD-HDF on the acid-base status of end-stage renal disease (ESRD) patients.
- To evaluate the efficacy of these treatments in correcting acidosis.
Main Methods:
- ESRD patients were treated alternately with HD, POD-HDF, and PRD-HDF using Fresenius 4008 On-Line HDF machines.
- Treatment parameters, particularly bicarbonate dialysate concentration, were kept constant across modes.
- Plasma bicarbonate (HCO3), pH, pCO2, pO2, and potassium (K+) levels were measured.
Main Results:
- No significant differences in acid-base parameters were observed between HD, POD-HDF, and PRD-HDF.
- All treatment modes effectively corrected metabolic acidosis in ESRD patients.
- No excessive compensatory responses in acid-base disturbances were detected.
Conclusions:
- High-flux HD, POD-HDF, and PRD-HDF demonstrate comparable efficacy in managing acid-base balance in ESRD patients.
- The choice of HDF mode (predilution vs. postdilution) does not significantly impact acid-base correction when other parameters are controlled.