Improvement of anemia in hemodialysis patients treated by hemodiafiltration with high-volume on-line-prepared substitution fluid

Giuseppe Bonforte, Paolo Grillo, Simona Zerbi, Maurizio Surian

Research output: Contribution to journalArticle

88 Citations (Scopus)

Abstract

Background: Hemodiafiltration (HDF) is associated with a lower incidence of neuropathy, carpal tunnel syndrome, joint pain, and partial correction of anemia. HDF with on-line-prepared substitution fluid (OL HDF), as compared with conventional hemodialysis, increases the treatment tolerance and, as compared with standard HDF, avoids storage problems and allows a higher substitution volume at low cost. Methods: Thirty-two hemodialysis patients treated by OL HDF for at least 9 months were studied. Hemoglobin, hematocrit, iron metabolism, serum albumin, dialysis dose and dry body weight were determined under a settled condition with regular hemodialysis 3 months before the transfer to OL HDF. The same parameters were analyzed 3, 6 and 9 months after the beginning of the new treatment modality. Results: During OL HDF, hemoglobin values significantly increased in patients without addition of recombinant human erythropoietin (rHuEPO): baseline vs. 6 months 11 ± 1.7 vs. 12 ± 1.8 g/dl (p <0.01); baseline vs. 9 months 11 ± 1.7 vs. 12 ± 1.6 g/dl (p <0.05). In patients on a maintenance dose of rhuEPO, this could be significantly reduced, while the target hemoglobin levels were maintained (10.6 ± 0.9 g/dl): baseline 99.8 ± 50.4 U/kg/week, 3rd month 76.2 ± 43 U/kg/week, 6th month 64.3 ± 37 U/kg/week, and 9th month 59.4 ± 38.6 U/kg/week (p = 0.007, p = 0.0006, and p = 0.0007, respectively, vs. baseline). Iron metabolism, dialysis dose, dry body weight and serum albumin levels did not significantly change during the follow-up period. Further, a stability of the rHuEPO supplementation was observed in 14 patients followed up for 24 months. Conclusions: OL HDF influences anemia and rHuEPO dose. It allows considerable anemia correction in patients without rHuEPO treatment, while it significantly reduces rHuEPO doses in those on rHuEPO treatment as compared with standard hemodialysis. The rHuEPO costs are consequently reduced.

Original languageEnglish
Pages (from-to)357-363
Number of pages7
JournalBlood Purification
Volume20
Issue number4
DOIs
Publication statusPublished - 2002

Fingerprint

Hemodiafiltration
Erythropoietin
Renal Dialysis
Anemia
Hemoglobins
Serum Albumin
Dialysis
Iron
Body Weight
Costs and Cost Analysis
Carpal Tunnel Syndrome
Arthralgia
Therapeutics
Hematocrit
Incidence

Keywords

  • Anemia
  • High-volume substitution fluid
  • On-line hemodiafiltration

ASJC Scopus subject areas

  • Nephrology
  • Hematology

Cite this

Improvement of anemia in hemodialysis patients treated by hemodiafiltration with high-volume on-line-prepared substitution fluid. / Bonforte, Giuseppe; Grillo, Paolo; Zerbi, Simona; Surian, Maurizio.

In: Blood Purification, Vol. 20, No. 4, 2002, p. 357-363.

Research output: Contribution to journalArticle

@article{8513d8be8623489192f95bd2154fdd74,
title = "Improvement of anemia in hemodialysis patients treated by hemodiafiltration with high-volume on-line-prepared substitution fluid",
abstract = "Background: Hemodiafiltration (HDF) is associated with a lower incidence of neuropathy, carpal tunnel syndrome, joint pain, and partial correction of anemia. HDF with on-line-prepared substitution fluid (OL HDF), as compared with conventional hemodialysis, increases the treatment tolerance and, as compared with standard HDF, avoids storage problems and allows a higher substitution volume at low cost. Methods: Thirty-two hemodialysis patients treated by OL HDF for at least 9 months were studied. Hemoglobin, hematocrit, iron metabolism, serum albumin, dialysis dose and dry body weight were determined under a settled condition with regular hemodialysis 3 months before the transfer to OL HDF. The same parameters were analyzed 3, 6 and 9 months after the beginning of the new treatment modality. Results: During OL HDF, hemoglobin values significantly increased in patients without addition of recombinant human erythropoietin (rHuEPO): baseline vs. 6 months 11 ± 1.7 vs. 12 ± 1.8 g/dl (p <0.01); baseline vs. 9 months 11 ± 1.7 vs. 12 ± 1.6 g/dl (p <0.05). In patients on a maintenance dose of rhuEPO, this could be significantly reduced, while the target hemoglobin levels were maintained (10.6 ± 0.9 g/dl): baseline 99.8 ± 50.4 U/kg/week, 3rd month 76.2 ± 43 U/kg/week, 6th month 64.3 ± 37 U/kg/week, and 9th month 59.4 ± 38.6 U/kg/week (p = 0.007, p = 0.0006, and p = 0.0007, respectively, vs. baseline). Iron metabolism, dialysis dose, dry body weight and serum albumin levels did not significantly change during the follow-up period. Further, a stability of the rHuEPO supplementation was observed in 14 patients followed up for 24 months. Conclusions: OL HDF influences anemia and rHuEPO dose. It allows considerable anemia correction in patients without rHuEPO treatment, while it significantly reduces rHuEPO doses in those on rHuEPO treatment as compared with standard hemodialysis. The rHuEPO costs are consequently reduced.",
keywords = "Anemia, High-volume substitution fluid, On-line hemodiafiltration",
author = "Giuseppe Bonforte and Paolo Grillo and Simona Zerbi and Maurizio Surian",
year = "2002",
doi = "10.1159/000063104",
language = "English",
volume = "20",
pages = "357--363",
journal = "Blood Purification",
issn = "0253-5068",
publisher = "S. Karger AG",
number = "4",

}

TY - JOUR

T1 - Improvement of anemia in hemodialysis patients treated by hemodiafiltration with high-volume on-line-prepared substitution fluid

AU - Bonforte, Giuseppe

AU - Grillo, Paolo

AU - Zerbi, Simona

AU - Surian, Maurizio

PY - 2002

Y1 - 2002

N2 - Background: Hemodiafiltration (HDF) is associated with a lower incidence of neuropathy, carpal tunnel syndrome, joint pain, and partial correction of anemia. HDF with on-line-prepared substitution fluid (OL HDF), as compared with conventional hemodialysis, increases the treatment tolerance and, as compared with standard HDF, avoids storage problems and allows a higher substitution volume at low cost. Methods: Thirty-two hemodialysis patients treated by OL HDF for at least 9 months were studied. Hemoglobin, hematocrit, iron metabolism, serum albumin, dialysis dose and dry body weight were determined under a settled condition with regular hemodialysis 3 months before the transfer to OL HDF. The same parameters were analyzed 3, 6 and 9 months after the beginning of the new treatment modality. Results: During OL HDF, hemoglobin values significantly increased in patients without addition of recombinant human erythropoietin (rHuEPO): baseline vs. 6 months 11 ± 1.7 vs. 12 ± 1.8 g/dl (p <0.01); baseline vs. 9 months 11 ± 1.7 vs. 12 ± 1.6 g/dl (p <0.05). In patients on a maintenance dose of rhuEPO, this could be significantly reduced, while the target hemoglobin levels were maintained (10.6 ± 0.9 g/dl): baseline 99.8 ± 50.4 U/kg/week, 3rd month 76.2 ± 43 U/kg/week, 6th month 64.3 ± 37 U/kg/week, and 9th month 59.4 ± 38.6 U/kg/week (p = 0.007, p = 0.0006, and p = 0.0007, respectively, vs. baseline). Iron metabolism, dialysis dose, dry body weight and serum albumin levels did not significantly change during the follow-up period. Further, a stability of the rHuEPO supplementation was observed in 14 patients followed up for 24 months. Conclusions: OL HDF influences anemia and rHuEPO dose. It allows considerable anemia correction in patients without rHuEPO treatment, while it significantly reduces rHuEPO doses in those on rHuEPO treatment as compared with standard hemodialysis. The rHuEPO costs are consequently reduced.

AB - Background: Hemodiafiltration (HDF) is associated with a lower incidence of neuropathy, carpal tunnel syndrome, joint pain, and partial correction of anemia. HDF with on-line-prepared substitution fluid (OL HDF), as compared with conventional hemodialysis, increases the treatment tolerance and, as compared with standard HDF, avoids storage problems and allows a higher substitution volume at low cost. Methods: Thirty-two hemodialysis patients treated by OL HDF for at least 9 months were studied. Hemoglobin, hematocrit, iron metabolism, serum albumin, dialysis dose and dry body weight were determined under a settled condition with regular hemodialysis 3 months before the transfer to OL HDF. The same parameters were analyzed 3, 6 and 9 months after the beginning of the new treatment modality. Results: During OL HDF, hemoglobin values significantly increased in patients without addition of recombinant human erythropoietin (rHuEPO): baseline vs. 6 months 11 ± 1.7 vs. 12 ± 1.8 g/dl (p <0.01); baseline vs. 9 months 11 ± 1.7 vs. 12 ± 1.6 g/dl (p <0.05). In patients on a maintenance dose of rhuEPO, this could be significantly reduced, while the target hemoglobin levels were maintained (10.6 ± 0.9 g/dl): baseline 99.8 ± 50.4 U/kg/week, 3rd month 76.2 ± 43 U/kg/week, 6th month 64.3 ± 37 U/kg/week, and 9th month 59.4 ± 38.6 U/kg/week (p = 0.007, p = 0.0006, and p = 0.0007, respectively, vs. baseline). Iron metabolism, dialysis dose, dry body weight and serum albumin levels did not significantly change during the follow-up period. Further, a stability of the rHuEPO supplementation was observed in 14 patients followed up for 24 months. Conclusions: OL HDF influences anemia and rHuEPO dose. It allows considerable anemia correction in patients without rHuEPO treatment, while it significantly reduces rHuEPO doses in those on rHuEPO treatment as compared with standard hemodialysis. The rHuEPO costs are consequently reduced.

KW - Anemia

KW - High-volume substitution fluid

KW - On-line hemodiafiltration

UR - http://www.scopus.com/inward/record.url?scp=0036060010&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0036060010&partnerID=8YFLogxK

U2 - 10.1159/000063104

DO - 10.1159/000063104

M3 - Article

VL - 20

SP - 357

EP - 363

JO - Blood Purification

JF - Blood Purification

SN - 0253-5068

IS - 4

ER -