Effect of acetate‐free biofiltration on the anaemia of haemodialysis patients: a prospective cross‐over study

Basile, Carlo; Giordano, Rosaria; Montanaro, Alessio; Maio, Pasquale De; Padova, F. De; Marangi, Anna Lisa; Semeraro, Angelo

doi:10.1093/ndt/16.9.1914

Cited by 14 publications

(3 citation statements)

References 14 publications

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“…Anemic patients in our study were treated with recombinant human erythropoietin (Epo). Well-randomized prospective studies did not prove significant differences in hematological parameters, no matter if the patients were treated by low- 31,32 Other studies, which included patients with Epo therapy, showed that in the high-flux dialysis group Epo doses were significantly lower and Hb levels showed a significant increase compared with the low-flux dialysis group, where Hb levels showed no significant increase, despite the steady increase in Epo doses. 33 When the SF-36 domains were analyzed, the lowest values were observed in role physical, physical function, and general health domains in all groups, which is in accordance with results of previous studies in HD patients.…”

Section: Discussionmentioning

confidence: 98%

Influence of Dialysis Modality and Membrane Flux on Quality of Life in Hemodialysis Patients

Knežević¹,

Djordjević²,

Radovanovic-Velickovic³

et al. 2012

Renal Failure

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Background: The quality of life in patients undergoing hemodialysis is significantly disturbed. There are data that hemodiafiltration (HDF) may be more effective than conventional hemodialysis in the removal of uremic toxins and may reduce frequency and severity of intradialytic and postdialysis adverse symptoms in patients. Also, some researchers suggest advantages of using high-flux membranes compared with low-flux. Objective: The aim of this study was to examine whether hemodialysis modality and membrane flux, independent of membrane biocompatibility, make differences in quality of life in patients. Methods: In our cross-sectional study, we evaluated 124 patients who were divided, based on therapy, into three groups: online HDF, high-flux hemodialysis, and low-flux hemodialysis. Data were collected using the Short Form-36 questionnaire combined with special questionnaire, which included demographic and clinically related questions. Results: Health-related quality of life was better in patients on HDF compared with patients on hemodialysis, especially compared with low-flux hemodialysis patients in most of the scales and in both dimensions: physical component scale and mental component scale. There were no statistically significant differences in Short Form-36 domains between high-flux hemodialysis and low-flux hemodialysis. Conclusion: Our data suggest the potential advantages of HDF with regard to influence on quality of life, which is sufficient to justify further research in prospective and longitudinal study design.

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Section: Discussionmentioning

confidence: 98%

Influence of Dialysis Modality and Membrane Flux on Quality of Life in Hemodialysis Patients

Knežević¹,

Djordjević²,

Radovanovic-Velickovic³

et al. 2012

Renal Failure

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“…In the interim, several studies have used surrogates such as assessment of nutrition, phosphate control, and erythropoietin requirements in patients treated by haemodiafiltration and haemodialysis. Although some studies have reported an improvement in nutritional parameters [7,8], serum phosphate control [9,10] and response to erythropoietin [11,12] with on-line haemodiafiltration, these have not been universal findings with other studies reporting no benefit [2], particularly when smaller volumes of ultrafiltration [13] or regenerating sorbent techniques were used [14]. …”

Section: Introductionmentioning

confidence: 99%

Haemodiafiltration versus High-Flux Haemodialysis: Effects on Phosphate Control and Erythropoietin Response

2010

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Introduction: Haemodiafiltration (HDF) has been reported to improve erythropoietin (EPO) responsiveness and phosphate clearance. We prospectively audited the effect of HDF on EPO dosages, weight and serum phosphate. Methods: 34 patients dialyzing on Tu/Th/Sa switched to HDF, and 44 dialyzing on M/W/F remained on high-flux haemodialysis (HD) and were followed for 12 months. Results: Dialysis adequacy (Kt/V start HDF 1.56 ± 0.03 vs. HD 1.58 ± 0.04 and 12 months 1.55 ± 0.03 vs. 1.59 ± 0.03), haemoglobin (start 11.7 ± 0.3 vs. 11,8 ± 0.2 g/dl and end 11.5 ± 0.1 vs. 11.3 ± 0.3 g/dl), weight (start 69.8 ± 2.4 vs. 67.8 ± 2.5 kg and end 67.4 ± 2.5 vs. 66.1 ± 2.3 kg), or EPO prescription (start 83 (61–186) vs. 123 (71–225) IU/kg/weeks and 12 months 142 (48–188) vs. 124 (59–223) IU/kg/weeks) did not differ. There were no differences in serum albumin, CRP, calcium and parathyroid hormone. Serum beta-2-microglobulin (B₂M) decreased with HDF (32.7 ± 1.9 vs. 28.1 ± 1.1 mg/l, p < 0.01), but not with HD (31.6 ± 1.4 vs. 31.5 ± 1.1 mg/l). Serum phosphate fell with HDF (start 1.48 ± 0.08 vs. 1.57 ± 0.07 mmol/l (p = NS); 3 months 1.35 ± 0.07 vs. 1.61 ± 0.08; 6 months 1.34 ± 0.06 vs. 1.57 ± 0.06, and 12 months 1.36 ± 0.07 vs. 1.67 ± 0.07, all p < 0.05). Conclusion: HDF did not lead to weight gain or improved EPO responsiveness in this prospective observational study. However, predialysis serum phosphate and B₂M fell with HDF.

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“…Total calcium, phosphate, and alkaline phosphatase were similar in both groups over the year. Basile et al 13 showed in 2001 that neither pre- nor post-dialysis systolic and diastolic blood pressures, pre-dialysis serum bicarbonate and pH, and pre-dialysis serum sodium, potassium, calcium, or phosphorus were significantly different when comparing hemodialysis and hemodiafiltration.…”

Section: Introductionmentioning

confidence: 99%

Skeletal and cardiovascular consequences of a positive calcium balance during hemodialysis

2021

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Patients on hemodialysis are exposed to calcium via the dialysate at least three times a week. Changes in serum calcium vary according to calcium mass transfer during dialysis, which is dependent on the gradient between serum and dialysate calcium concentration (d[Ca]) and the skeleton turnover status that alters the ability of bone to incorporate calcium. Although underappreciated, the d[Ca] can potentially cause positive calcium balance that leads to systemic organ damage, including associations with mortality, myocardial dysfunction, hemodynamic tolerability, vascular calcification, and arrhythmias. The pathophysiology of these adverse effects includes serum calcium changes, parathyroid hormone suppression, and vascular calcification through indirect and direct effects. Some organs are more susceptible to alterations in calcium homeostasis. In this review, we discuss the existing data and potential mechanisms linking the d[Ca] to calcium balance with consequent dysfunction of the skeleton, myocardium, and arteries.

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Effect of acetate‐free biofiltration on the anaemia of haemodialysis patients: a prospective cross‐over study

Cited by 14 publications

References 14 publications

Influence of Dialysis Modality and Membrane Flux on Quality of Life in Hemodialysis Patients

Influence of Dialysis Modality and Membrane Flux on Quality of Life in Hemodialysis Patients

Haemodiafiltration versus High-Flux Haemodialysis: Effects on Phosphate Control and Erythropoietin Response

Skeletal and cardiovascular consequences of a positive calcium balance during hemodialysis

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