On‐line Hemodiafiltration Does Not Induce Inflammatory Response in End‐stage Renal Disease Patients: Results From a Multicenter Cross‐over Study

Vaslaki, Lajos; Berta, Klára; Major, Lajos; Weber, Viktoria; Weber, Christoph; Wojke, Ralf; Passlick–Deetjen, Jutta; Falkenhagen, D

doi:10.1111/j.1525-1594.2005.29068.x

Cited by 35 publications

(30 citation statements)

References 35 publications

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“…One of the nutritional aspects in dialysis patients is loss of albumin, which depends on the permeability of the membrane used, and increases with increasing ultrafiltrate rates and transmembrane pressures. Some earlier studies either showed no change or even an improvement of albumin levels [30,33,35,37,38]. In the CONTRAST study, a decrease in albumin levels by 1.4% was seen after 6 months of treatment with HDF, while the levels remained stable in the HD group [36].…”

Section: Hdf and Hard Clinical End Pointsmentioning

confidence: 97%

“…Although this has indeed been shown for TNF and IL-1, no effect of HDF on the clearance of IL-6R has been demonstrated thus far [25,26,28,30]. HDF with regeneration of ultrafiltrate has been reported to have a positive impact on inflammation and oxidative stress as well.…”

Section: Effects Of Hdf On Uremic Inflammationmentioning

confidence: 99%

“…By using a virtually unlimited amount of sterile dialysis fluid in the form of ultrapure dialysis fluid and high-flux synthetic membranes, HDF offers a highly biocompatible dialysis system. Vaslaki et al [30] investigated the effect of HDF versus low-flux HD on several inflammatory biomarkers, and found no difference between the dialysis modalities. It was concluded that HDF did not induce an inflammatory response.…”

Section: Effects Of Hdf On Uremic Inflammationmentioning

confidence: 99%

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Effects of Hemodiafiltration on Uremic Inflammation

2013

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Chronic inflammation is highly prevalent among end-stage renal disease patients and is linked to, and thought to contribute to, the high morbidity and mortality in this patient population. Hemodiafiltration (HDF) may potentially reduce inflammatory stimuli induced by the bioincompatibility of conventional hemodialysis (HD) systems. In addition, HDF may more efficiently remove inflammatory mediators. This brief review shows that the circulating levels of various markers of systemic inflammation in general are somewhat reduced in patients treated by HDF as compared to HD. On the other hand, according to the current literature, this favorable small impact on inflammation biomarkers does not seem to translate into better clinical outcomes. It is possible that this is due to inadequate design, inadequate number of investigated patients and too short duration of previous studies. The results of larger, better-designed ongoing prospective studies may hopefully clarify this.

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Section: Hdf and Hard Clinical End Pointsmentioning

confidence: 97%

Section: Effects Of Hdf On Uremic Inflammationmentioning

confidence: 99%

Section: Effects Of Hdf On Uremic Inflammationmentioning

confidence: 99%

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Effects of Hemodiafiltration on Uremic Inflammation

2013

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“…Several studies have shown that RKF or urine volume was more preserved among patients treated with on-line HDF than among those treated with conventional hemodialysis [78, 79]. These observations may be attributed to fewer intradialytic hypotensive episodes and reduced dialyzer-induced systemic inflammation [80]. …”

Section: How To Protect Rkfmentioning

confidence: 97%

Individualized Hemodialysis Treatment: A Perspective on Residual Kidney Function and Precision Medicine in Nephrology

Hur

Lee²,

Kalantar-Zadeh³

et al. 2018

Cardiorenal Med

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Background: Residual kidney function (RKF) is often expected to inevitably and rapidly decline among hemodialysis patients and, hence, has been inadvertently ignored in clinical practice. The importance of RKF has been revisited in some recent studies. Given that patients with end-stage renal disease now tend to initiate maintenance hemodialysis therapy with higher RKF levels, there seem to be important opportunities for incremental hemodialysis by individualizing the dose and frequency according to their RKF levels. This approach is realigned with precision medicine and patient-centeredness. Summary: In this article, we first review the available methods to estimate RKF among hemodialysis patients. We then discuss the importance of maintaining and monitoring RKF levels based on a variety of clinical aspects, including volume overload, blood pressure control, mineral and bone metabolism, nutrition, and patient survival. We also review several potential measures to protect RKF: the use of high-flux and biocompatible membranes, the use of ultrapure dialysate, the incorporation of hemodiafiltration, incremental hemodialysis, and a low-protein diet, as well as general care such as avoiding nephrotoxic events, maintaining appropriate blood pressure, and better control of mineral and bone disorder parameters. Key Message: Individualized hemodialysis regimens may maintain RKF, lead to a better quality of life without compromising long-term survival, and ensure precision medicine and patient-centeredness in nephrology practice.

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“…Apart from other forms of HDF (acetate-free biofi ltration, push-pull, mid-dilution, paired fi ltration dialysis), online HDF has constantly increased its popularity, possibly based on the following facts. Firstly, the unlimited amount of fl uid which can be produced online under proven and experience-based safety protocols will further encourage the application of increased convection [57] . New perspectives in the use of pre-and postinfusion, controlled by the transmembrane pressure ultrafi ltration feedback, may enable a more complete exploitation of the convective mechanism [58] .…”

Section: From Expensive Technical Gadgets To Useful Tools For Routinementioning

confidence: 99%

Dialysis Patients and Cardiovascular Problems: Can Technology Help Solve the Complex Equation?

Ronco¹,

Bowry²,

Tetta³

2005

Blood Purif

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Patients with end-stage kidney disease undergoing chronic hemodialysis (HD) present higher mortality rates compared with the general population. Once patients are on HD, the risk of cardiovascular death is approximately 30 times higher than in the general population and remains 10–20 times higher after stratification for age, gender, and the presence of diabetes. About half the deaths of patients on dialysis are attributed to cardiovascular causes including coronary heart disease, cerebrovascular disease, peripheral vascular disease, and heart failure. The cardiovascular burden of the HD patient arises from three different sources: risks inherent to the patient and the uremic syndrome, traditional risk factors, and risk factors related to the dialysis therapy. Based on these considerations and the fact that several aspects of the dialysis procedure can either add to the cardiovascular burden or modify the existing burden, new technologies should be directed towards the approach of a potential ‘cardioprotective dialysis therapy’; such an approach may be facilitated by the application of new techniques and advanced dialysis machines. Created to make dialysis easy and safe, new machines feature several options that make patient monitoring and online hemodiafiltration therapy routine procedures. These and other features will possibly make dialysis better tolerated and more efficient in protecting patients from undesirable or potentially fatal cardiovascular events.

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On‐line Hemodiafiltration Does Not Induce Inflammatory Response in End‐stage Renal Disease Patients: Results From a Multicenter Cross‐over Study

Abstract: On-line HDF, as the most effective renal replacement therapy, does not provoke inflammatory response and is both safe and highly biocompatible.

Cited by 35 publications

References 35 publications

Effects of Hemodiafiltration on Uremic Inflammation

Effects of Hemodiafiltration on Uremic Inflammation

Individualized Hemodialysis Treatment: A Perspective on Residual Kidney Function and Precision Medicine in Nephrology

Dialysis Patients and Cardiovascular Problems: Can Technology Help Solve the Complex Equation?

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