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online HDF

Sebastian Mas, Enrique Bosch-Panadero, Pedro Abaigar, Vanesa Camarero, Ignacio Mahillo, Esther Civantos, Didier Sanchez-Ospina, Alberto Ruiz-Priego, Jesus Egido, Alberto Ortiz, Emilio González-Parra
INTRODUCTION: Bisphenol A (BPA) is an ubiquitous environmental toxin that is also found in dialyzers. Online hemodiafiltration (OL-HDF) more efficiently clears high molecular weight molecules, and this may improve BPA clearance. However, the BPA contents of dialysis membranes may be a source of BPA loading during OL-HDF. METHODS: A prospective study assessed plasma BPA levels in OL-HDF patients using BPA-free (polynephron) or BPA-containing (polysulfone) dialyzers in a crossover design with two arms, after a run-in OL-HDF period of at least 6 months with the same membrane: 31 patients on polynephron at baseline were switched to polysulfone membranes for 3 months (polynephron-to-polysulfone) and 29 patients on polysulfone were switched to polynephron for 3 months (polysulfone-to-polynephron)...
2018: PloS One
Khajohn Tiranathanagul, Paweena Susantitaphong, Nattachai Srisawat, Nanta Mahatanan, Kriang Tungsanga, Kearkiat Praditpornsilpa, Somchai Eiam-Ong
BACKGROUND: Recently, in the first hemodiafiltration (HDF) experience report from South East Asia (SEA), we reported a 3-year prospective study demonstrating the various short-term benefits of high-efficiency online HDF (OL-HDF) over high-flux hemodialysis (HD). Very few long-term survival reports of high-efficiency OL-HDF are available and the data are heterogeneous and incomplete. OBJECTIVES: The present historical cohort study was conducted to determine the long-term survival and outcome of high-efficiency OL-HDF-treated patients...
March 7, 2018: Nephron
Richard A Ward, Jörg Vienken, Douglas M Silverstein, Stephen Ash, Bernard Canaud
Online hemodiafiltration provides greater removal of higher molecular weight uremic retention solutes than conventional high-flux hemodialysis. However, online hemodiafiltration is used sparsely in the United States in part because of a paucity of delivery systems cleared for clinical use by the US Food and Drug Administration. Although a pathway for regulatory approval exists in the United States, concerns remain, particularly regarding online production of the large volumes of sterile, nonpyrogenic substitution fluid infused directly into the bloodstream to maintain fluid balance...
March 6, 2018: Clinical Journal of the American Society of Nephrology: CJASN
Bernard Canaud, Jörg Vienken, Stephen Ash, Richard A Ward
Hemodiafiltration combines diffusive and convective solute removal in a single therapy by ultrafiltering 20% or more of the blood volume processed using a high-flux hemodialyzer and maintaining fluid balance by infusing sterile nonpyrogenic replacement fluid directly into the patient's blood. In online hemodiafiltration, the large volumes of replacement fluid required are obtained by online filtration of standard dialysate through a series of bacteria- and endotoxin-retaining filters. Currently available systems for online hemodiafiltration are on the basis of conventional dialysis machines with added features to safely prepare and infuse replacement fluid and closely control fluid balance...
March 6, 2018: Clinical Journal of the American Society of Nephrology: CJASN
Pablo Molina, Belén Vizcaíno, Mariola D Molina, Sandra Beltrán, Mercedes González-Moya, Antonio Mora, Cristina Castro-Alonso, Julia Kanter, Ana I Ávila, José L Górriz, Nuria Estañ, Luis M Pallardó, Denis Fouque, Juan J Carrero
Background: Compared with conventional haemodialysis (HD), online haemodiafiltration (OL-HDF) achieves a more efficient removal of uraemic toxins and reduces inflammation, which could favourably affect nutritional status. We evaluate the effect of OL-HDF on body composition and nutritional status in prevalent high-flux HD (HF-HD) patients. Methods: In all, 33 adults with chronic kidney disease (CKD) Stage 5 undergoing maintenance HF-HD were assigned to post-dilution OL-HDF (n = 17) or to remain on HF-HD (n = 16, control group) for 12 months...
January 22, 2018: Nephrology, Dialysis, Transplantation
Francisco Maduell, Raquel Ojeda, Lara Belmar, Paula Munguía, Cristina Sango, Ana Isabel Martinez-Díaz, Marta Arias-Guillén, Manel Vera, Néstor Fontseré, Miquel Gómez, Lida Rodas, Nayra Rico
INTRODUCTION: Online haemodiafiltration (OL-HDF) has been associated with increased survival. To date, the influence of the inner diameter of the hollow fibres of the dialyser on convective volume has not been well established. The objective of the study was to evaluate the effect of increasing the inner diameter of the dialyser on the convective volume and removal capacity. MATERIAL AND METHODS: We included 16 patients in posdilutional OL-HDF with autosubstitution...
January 2018: Nefrología: Publicación Oficial de la Sociedad Española Nefrologia
Camiel L M de Roij van Zuijdewijn, Isabelle Chapdelaine, Menso J Nubé, Peter J Blankestijn, Michiel L Bots, Constantijn J A M Konings, Ton K Kremer Hovinga, Femke M Molenaar, Neelke C van der Weerd, Muriel P C Grooteman
Background. Available evidence suggests a reduced mortality risk for patients treated with high-volume postdilution hemodiafiltration (HDF) when compared with hemodialysis (HD) patients. As the magnitude of the convection volume depends on treatment-related factors rather than patient-related characteristics, we prospectively investigated whether a high convection volume (defined as ≥22 L/session) is feasible in the majority of patients (>75%). Methods. A multicenter study was performed in adult prevalent dialysis patients...
December 2017: Clinical Kidney Journal
Francisco Maduell, Raquel Ojeda, Marta Arias-Guillén, Néstor Fontseré, Manel Vera, Lida Rodas, Miquel Gómez, Karen P Huablocho, Fanny Esquivel, Paola D Mori, Valentina Hoffmann, Jessica Ugalde, Nayra Rico
BACKGROUND: Online haemodiafiltration (OL-HDF) is currently the most effective dialysis technique that also improves survival. To date, high permeability membranes with low albumin loss, such as polysulfone, polyamide and polyacrylonitrile membranes have been the most widely used. However, the initially restricted use of cellulose triacetate (CTA) membranes in OL-HDF has expanded. The aim of the study was to ascertain whether the latest generation asymmetric CTA membranes are more effective in obtaining high convective transport...
March 2018: Nefrología: Publicación Oficial de la Sociedad Española Nefrologia
Yuta Yokoyama, Kakine Nishino, Kazuaki Matsumoto, Yuki Inomoto, Kaori Matsuda, Rin-Nosuke Nakamura, Nobuhiro Yasuno, Junko Kizu
The purpose of this study was to estimate the in vivo pharmacokinetics of meropenem during intermittent-infusion hemodiafiltration (I-HDF) and clarify its optimal dosage and dosing interval in patients receiving I-HDF. The clearance of meropenem by online hemodiafiltration (OL-HDF) and I-HDF was predicted using an in vitro system and assessed to establish whether the results obtained are applicable to clinical cases. In the in vivo study, the mean volume of distribution (Vd), non-I-HDF clearance (CLnon-I-HDF), and I-HDF clearance (CLI-HDF) were 15...
October 17, 2017: Journal of Infection and Chemotherapy: Official Journal of the Japan Society of Chemotherapy
Almudena Vega, Soraya Abad, Nicolás Macías, Inés Aragoncillo
Survival with online hemodiafiltration (OL-HDF) is higher than with hemodialysis; frequent hemodialysis has also improved survival and quality of life. Home hemodialysis facilitates frequent therapy. We report our experience with 2 patients with stage 5 CKD who started home hemodialysis with OL-HDF in November 2016. After a training period at the hospital, they started home hemodialysis with OL-HDF after learning how to manage dialysis monitors and how to administer water treatment. We used the "5008-home" (FMC© ) monitor, and the Acqua C© (Fresenius Medical Care) for water treatment...
October 3, 2017: Hemodialysis International
Isabel Galán, Marian Goicoechea, Borja Quiroga, Nicolás Macías, Alba Santos, Maria Soledad García de Vinuesa, Úrsula Verdalles, Santiago Cedeño, Eduardo Verde, Ana Pérez de José, Ana García, José Luño
BACKGROUND AND OBJECTIVES: Hyperuricemia plays a major role in the development and progression of chronic kidney disease (CKD). Many large observational studies have indicated that increased serum uric acid level predicts the development and progression of CKD in some population, however this hypothesis has not been yet studied in patients with reduced renal mass. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: Retrospective study with a cohort of 324 patients with reduced renal mass from an outpatient basis, followed during 60 (36-98) months...
January 2018: Nefrología: Publicación Oficial de la Sociedad Española Nefrologia
Nicolás Macías, Almudena Vega, Soraya Abad, Alba Santos, Santiago Cedeño, Tania Linares, Ana María García-Prieto, Inés Aragoncillo, Claudia Yuste, Juan Manuel López-Gómez
Chronic malnutrition is a common problem in patients with end-stage renal disease on hemodialysis. Some studies have reported albumin loss into dialysis fluid during postdilution online hemodiafiltration (OL-HDF). The aim of the study was to assess the nutritional status of patients on high-volume OL-HDF and to demonstrate that higher convective clearances are not associated with malnutrition due to possible loss of nutrients with ultrafiltration. Demographic and clinical data, corporal composition with bioimpedance spectroscopy, dialysis features, albumin loss into dialysis fluid and laboratory parameters were collected in twenty-eight patients with ESRD undergoing postdilution OL-HDF with stable convective volumes over 28 L/session...
August 2017: Therapeutic Apheresis and Dialysis
Kamonwan Tangvoraphonkchai, Anne Riddell, Andrew Davenport
INTRODUCTION: Hemodialysis patients are pro-thrombotic. Higher volume online postdilutional hemodiafiltration (OL-HDF), with increasing hematocrit increases the risk of clotting in the extracorporeal circuit (ECC). We wished to determine whether OL-HDF increased platelet activation and ECC clotting. METHODS: Coagulation parameters, platelet, white cell, and endothelial activation markers were measured at the start and end of dialysis sessions in 10 patients and also pre- and post-dialyzer after 15 minutes using two different dialyzers designed for high volume OL-HDF; cellulose triacetate (TAGP) and polysulphone (PS), and polyvinylpyrrolidone (PVP)...
August 1, 2017: Hemodialysis International
Olga Hilda Orasan, Aniela Pop Saplontai, Angela Cozma, Simona Racasan, Ina Maria Kacso, Crina Claudia Rusu, Diana Moldovan, Dacian Tirinescu, Alina Potra, Ioan Mihai Patiu, Remus Aurel Orasan
INTRODUCTION: Insomnia, muscular cramps, pruritus and postdialysis recovery time (RT) are quality-of-life parameters that affect hemodialysis (HD) patients physically and mentally. METHODS: We included 171 end-stage renal disease patients: 115 on high-flux HD and 56 on online hemodiafiltration (HDF). Patients were asked "How long does it take you to recover from a dialysis session?" and they evaluated intensity (absent, mild, medium and severe) of insomnia, muscular cramps and pruritus in the past 4 weeks...
September 2017: International Urology and Nephrology
Takuya Wakamatsu, Suguru Yamamoto, Kenya Kamimura, Takeshi Nakatsue, Noriaki Iino, Seitaro Iguchi, Yoshikatsu Kaneko, Shin Goto, Junichiro James Kazama, Ichiei Narita
A 36-year-old woman who was undergoing dialysis for end-stage kidney disease (ESKD) was admitted to our hospital with consciousness disorder. She was diagnosed with Budd-Chiari syndrome due to antiphospholipid syndrome at the age of 28 years. Her kidney function and leg edema gradually deteriorated. After initiation of hemodialysis (HD), transient loss of consciousness due to hepatic encephalopathy during HD treatment occurred frequently. Her kidney replacement therapy was changed to online hemodiafiltration (HDF), which dramatically improved her hepatic coma...
November 2016: CEN Case Reports
Pasquale Esposito, Edoardo La Porta, Marta Calatroni, Maria Antonietta Grignano, Samantha Milanesi, Daniela Verzola, Yuri Battaglia, Marilena Gregorini, Carmelo Libetta, Giacomo Garibotto, Teresa Rampino
Background. In this study we investigated the relevance of myostatin and Hepatocyte Growth Factor (HGF) in patients undergoing hemodialysis HD and the influence of different HD modalities on their levels. Methods. We performed a prospective crossover study in which HD patients were randomized to undergo 3-month treatment periods with bicarbonate hemodialysis (BHD) followed by online hemodiafiltration (HDF). Clinical data, laboratory parameters, and myostatin and HGF serum levels were collected and compared...
2017: BioMed Research International
Nynke G L Jager, Anthe S Zandvliet, Daniel J Touw, Erik L Penne
Online haemodiafiltration (HDF) is increasingly used in clinical practice as a routine intermittent dialysis modality. It is well known that renal impairment and renal replacement therapy can substantially affect the pharmacokinetic behaviour of several drugs. However, surprisingly few data are available on the need for specific dose adjustments during HDF. Due to convection, drug clearance may be increased during HDF as compared with standard haemodialysis. This may be of particular interest in patients undergoing anti-infective therapy, since under-dosing may compromise patient outcomes and promote the emergence of bacterial resistance...
April 2017: Clinical Kidney Journal
Nicolás Macías, Alba Santos García, Almudena Vega Martínez, Soraya Abad Estébanez, Marian Goicoechea Diezhandino, Juan Manuel López Gómez
High-volume online hemodiafiltration (OL-HDF) has been associated with improved patient survival compared to conventional hemodialysis in recent trials, where the importance of convective volume (CV) in this benefit is noted. The purpose of this study was to determine the corporal composition parameters influencing the efficacy of CV in the removal of different molecular weight (MW) molecules. Demographic data, corporal composition parameters with bioimpedance spectroscopy, dialysis features and the reduction rates of different MW molecules in a four-hour OL-HDF session were collected in 61 patients...
February 2017: Therapeutic Apheresis and Dialysis
Menso J Nubé, Sanne A E Peters, Peter J Blankestijn, Bernard Canaud, Andrew Davenport, Muriel P C Grooteman, Gulay Asci, Francesco Locatelli, Francisco Maduell, Marion Morena, Ercan Ok, Ferran Torres, Michiel L Bots
Background: From an individual participant data (IPD) meta-analysis from four randomized controlled trials comparing haemodialysis (HD) with post-dilution online-haemodiafiltration (ol-HDF), previously it appeared that HDF decreases all-cause mortality by 14% (95% confidence interval 25; 1) and fatal cardiovascular disease (CVD) by 23% (39; 3). Significant differences were not found for fatal infections and sudden death. So far, it is unclear, however, whether the reduced mortality risk of HDF is only due to a decrease in CVD events and if so, which CVD in particular is prevented, if compared with HD...
March 1, 2017: Nephrology, Dialysis, Transplantation
James R Smith, Norica Zimmer, Elizabeth Bell, Bernard G Francq, Alex McConnachie, Robert Mactier
BACKGROUND: The choice between hemodiafiltration (HDF) or high-flux hemodialysis (HD) to treat end-stage kidney disease remains a matter of debate. The duration of recovery time after treatment has been associated with mortality, affects quality of life, and may therefore be important in informing patient choice. We aimed to establish whether recovery time is influenced by treatment with HDF or HD. STUDY DESIGN: Randomized patient-blinded crossover trial. SETTINGS & PARTICIPANTS: 100 patients with end-stage kidney disease were enrolled from 2 satellite dialysis units in Glasgow, United Kingdom...
June 2017: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
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