On-line predilution hemofiltration versus ultrapure high-flux hemodialysis: A multicenter prospective study in 23 patients

P. Altieri, G. B. Sorba, P. G. Bolasco, M. Bostrom, E. Asproni, R. Ferrara, F. Bolasco, M. Cossu, F. Cadinu, G. F. Cabiddu, D. Casu, M. Ganadu, M. Passaghe, M. Pinna

Research output: Contribution to journalArticle

51 Citations (Scopus)

Abstract

The aims of the present prospective multicenter study were to assess the clinical tolerance and well being, the correlation between nPCr and Kt/V and the pretreatment β2-microglobulin level in patients sequentially treated with high-flux dialysis with ultrapure bicarbonate hemodialysis (HD; phase I) and predilution hemofiltration (HF) with on-line prepared bicarbonate substitution fluid (phase II). The same monitor (Gambro AK 100 ULTRA®) and membrane (polyamide) were used. Twenty-three patients, all in a stable clinical condition, entered the study. The treatment was targeted to an equilibrated Kt/V (eqKt/V) of 1.4 for HD and 1.0 for HF. No mortality or relevant morbidity were observed. The number of hypotensive episodes was 1.78 ± 2.8 per patient and month during HD vs. 1.17 ± 3.1 during HF (p = 0.003) and the number of the hypertensive episodes 1.28 ± 2.8 during HD vs. 0.42 ± 0.8 during HF (p = 0.04). Incidences of arrhythmia, muscular cramps and headache were significantly less frequent during HF. Interdialytic cramps, arthralgia and fatigue were also significantly less frequent during the HF period. The average β2-microglobulin level was 27.1 ± 14.7 mg/dl at the start of the study, 22.9 ± 4.9 mg/dl at the beginning of phase II and 22.4 ± 4 mg/dl at the end of phase II (p = 0.01 compared to the start). A significant linear correlation between the normalized protein catabolic rate and eqKt/V was obtained faster during HD than during HF (45 vs. 120 days) indicating that HF affects the nutritional status with mechanisms different from HD. The present study is in agreement with the hypothesis that HF gives an adequate nutritional status with improved clinical stability and well being at a lower Kt/V compared to HD. Both therapies were efficient in controlling the pretreatment β2-microglobulin level.

Original languageEnglish
Pages (from-to)169-181
Number of pages13
JournalBlood Purification
Volume15
Issue number3
Publication statusPublished - May 1997

Fingerprint

Hemofiltration
Multicenter Studies
Renal Dialysis
Prospective Studies
Muscle Cramp
Bicarbonates
Nutritional Status
Nylons
Arthralgia
Fatigue
Headache
Cardiac Arrhythmias
Dialysis
Morbidity
Membranes
Mortality

Keywords

  • Kt/V
  • nPCR
  • One-line predilution hemofiltration
  • Ultrapure high-flux hemodialysis

ASJC Scopus subject areas

  • Nephrology
  • Hematology

Cite this

Altieri, P., Sorba, G. B., Bolasco, P. G., Bostrom, M., Asproni, E., Ferrara, R., ... Pinna, M. (1997). On-line predilution hemofiltration versus ultrapure high-flux hemodialysis: A multicenter prospective study in 23 patients. Blood Purification, 15(3), 169-181.

On-line predilution hemofiltration versus ultrapure high-flux hemodialysis : A multicenter prospective study in 23 patients. / Altieri, P.; Sorba, G. B.; Bolasco, P. G.; Bostrom, M.; Asproni, E.; Ferrara, R.; Bolasco, F.; Cossu, M.; Cadinu, F.; Cabiddu, G. F.; Casu, D.; Ganadu, M.; Passaghe, M.; Pinna, M.

In: Blood Purification, Vol. 15, No. 3, 05.1997, p. 169-181.

Research output: Contribution to journalArticle

Altieri, P, Sorba, GB, Bolasco, PG, Bostrom, M, Asproni, E, Ferrara, R, Bolasco, F, Cossu, M, Cadinu, F, Cabiddu, GF, Casu, D, Ganadu, M, Passaghe, M & Pinna, M 1997, 'On-line predilution hemofiltration versus ultrapure high-flux hemodialysis: A multicenter prospective study in 23 patients', Blood Purification, vol. 15, no. 3, pp. 169-181.
Altieri P, Sorba GB, Bolasco PG, Bostrom M, Asproni E, Ferrara R et al. On-line predilution hemofiltration versus ultrapure high-flux hemodialysis: A multicenter prospective study in 23 patients. Blood Purification. 1997 May;15(3):169-181.
Altieri, P. ; Sorba, G. B. ; Bolasco, P. G. ; Bostrom, M. ; Asproni, E. ; Ferrara, R. ; Bolasco, F. ; Cossu, M. ; Cadinu, F. ; Cabiddu, G. F. ; Casu, D. ; Ganadu, M. ; Passaghe, M. ; Pinna, M. / On-line predilution hemofiltration versus ultrapure high-flux hemodialysis : A multicenter prospective study in 23 patients. In: Blood Purification. 1997 ; Vol. 15, No. 3. pp. 169-181.
@article{32df570c96ac4aa3ac48b54592b18bf0,
title = "On-line predilution hemofiltration versus ultrapure high-flux hemodialysis: A multicenter prospective study in 23 patients",
abstract = "The aims of the present prospective multicenter study were to assess the clinical tolerance and well being, the correlation between nPCr and Kt/V and the pretreatment β2-microglobulin level in patients sequentially treated with high-flux dialysis with ultrapure bicarbonate hemodialysis (HD; phase I) and predilution hemofiltration (HF) with on-line prepared bicarbonate substitution fluid (phase II). The same monitor (Gambro AK 100 ULTRA{\circledR}) and membrane (polyamide) were used. Twenty-three patients, all in a stable clinical condition, entered the study. The treatment was targeted to an equilibrated Kt/V (eqKt/V) of 1.4 for HD and 1.0 for HF. No mortality or relevant morbidity were observed. The number of hypotensive episodes was 1.78 ± 2.8 per patient and month during HD vs. 1.17 ± 3.1 during HF (p = 0.003) and the number of the hypertensive episodes 1.28 ± 2.8 during HD vs. 0.42 ± 0.8 during HF (p = 0.04). Incidences of arrhythmia, muscular cramps and headache were significantly less frequent during HF. Interdialytic cramps, arthralgia and fatigue were also significantly less frequent during the HF period. The average β2-microglobulin level was 27.1 ± 14.7 mg/dl at the start of the study, 22.9 ± 4.9 mg/dl at the beginning of phase II and 22.4 ± 4 mg/dl at the end of phase II (p = 0.01 compared to the start). A significant linear correlation between the normalized protein catabolic rate and eqKt/V was obtained faster during HD than during HF (45 vs. 120 days) indicating that HF affects the nutritional status with mechanisms different from HD. The present study is in agreement with the hypothesis that HF gives an adequate nutritional status with improved clinical stability and well being at a lower Kt/V compared to HD. Both therapies were efficient in controlling the pretreatment β2-microglobulin level.",
keywords = "Kt/V, nPCR, One-line predilution hemofiltration, Ultrapure high-flux hemodialysis",
author = "P. Altieri and Sorba, {G. B.} and Bolasco, {P. G.} and M. Bostrom and E. Asproni and R. Ferrara and F. Bolasco and M. Cossu and F. Cadinu and Cabiddu, {G. F.} and D. Casu and M. Ganadu and M. Passaghe and M. Pinna",
year = "1997",
month = "5",
language = "English",
volume = "15",
pages = "169--181",
journal = "Blood Purification",
issn = "0253-5068",
publisher = "S. Karger AG",
number = "3",

}

TY - JOUR

T1 - On-line predilution hemofiltration versus ultrapure high-flux hemodialysis

T2 - A multicenter prospective study in 23 patients

AU - Altieri, P.

AU - Sorba, G. B.

AU - Bolasco, P. G.

AU - Bostrom, M.

AU - Asproni, E.

AU - Ferrara, R.

AU - Bolasco, F.

AU - Cossu, M.

AU - Cadinu, F.

AU - Cabiddu, G. F.

AU - Casu, D.

AU - Ganadu, M.

AU - Passaghe, M.

AU - Pinna, M.

PY - 1997/5

Y1 - 1997/5

N2 - The aims of the present prospective multicenter study were to assess the clinical tolerance and well being, the correlation between nPCr and Kt/V and the pretreatment β2-microglobulin level in patients sequentially treated with high-flux dialysis with ultrapure bicarbonate hemodialysis (HD; phase I) and predilution hemofiltration (HF) with on-line prepared bicarbonate substitution fluid (phase II). The same monitor (Gambro AK 100 ULTRA®) and membrane (polyamide) were used. Twenty-three patients, all in a stable clinical condition, entered the study. The treatment was targeted to an equilibrated Kt/V (eqKt/V) of 1.4 for HD and 1.0 for HF. No mortality or relevant morbidity were observed. The number of hypotensive episodes was 1.78 ± 2.8 per patient and month during HD vs. 1.17 ± 3.1 during HF (p = 0.003) and the number of the hypertensive episodes 1.28 ± 2.8 during HD vs. 0.42 ± 0.8 during HF (p = 0.04). Incidences of arrhythmia, muscular cramps and headache were significantly less frequent during HF. Interdialytic cramps, arthralgia and fatigue were also significantly less frequent during the HF period. The average β2-microglobulin level was 27.1 ± 14.7 mg/dl at the start of the study, 22.9 ± 4.9 mg/dl at the beginning of phase II and 22.4 ± 4 mg/dl at the end of phase II (p = 0.01 compared to the start). A significant linear correlation between the normalized protein catabolic rate and eqKt/V was obtained faster during HD than during HF (45 vs. 120 days) indicating that HF affects the nutritional status with mechanisms different from HD. The present study is in agreement with the hypothesis that HF gives an adequate nutritional status with improved clinical stability and well being at a lower Kt/V compared to HD. Both therapies were efficient in controlling the pretreatment β2-microglobulin level.

AB - The aims of the present prospective multicenter study were to assess the clinical tolerance and well being, the correlation between nPCr and Kt/V and the pretreatment β2-microglobulin level in patients sequentially treated with high-flux dialysis with ultrapure bicarbonate hemodialysis (HD; phase I) and predilution hemofiltration (HF) with on-line prepared bicarbonate substitution fluid (phase II). The same monitor (Gambro AK 100 ULTRA®) and membrane (polyamide) were used. Twenty-three patients, all in a stable clinical condition, entered the study. The treatment was targeted to an equilibrated Kt/V (eqKt/V) of 1.4 for HD and 1.0 for HF. No mortality or relevant morbidity were observed. The number of hypotensive episodes was 1.78 ± 2.8 per patient and month during HD vs. 1.17 ± 3.1 during HF (p = 0.003) and the number of the hypertensive episodes 1.28 ± 2.8 during HD vs. 0.42 ± 0.8 during HF (p = 0.04). Incidences of arrhythmia, muscular cramps and headache were significantly less frequent during HF. Interdialytic cramps, arthralgia and fatigue were also significantly less frequent during the HF period. The average β2-microglobulin level was 27.1 ± 14.7 mg/dl at the start of the study, 22.9 ± 4.9 mg/dl at the beginning of phase II and 22.4 ± 4 mg/dl at the end of phase II (p = 0.01 compared to the start). A significant linear correlation between the normalized protein catabolic rate and eqKt/V was obtained faster during HD than during HF (45 vs. 120 days) indicating that HF affects the nutritional status with mechanisms different from HD. The present study is in agreement with the hypothesis that HF gives an adequate nutritional status with improved clinical stability and well being at a lower Kt/V compared to HD. Both therapies were efficient in controlling the pretreatment β2-microglobulin level.

KW - Kt/V

KW - nPCR

KW - One-line predilution hemofiltration

KW - Ultrapure high-flux hemodialysis

UR - http://www.scopus.com/inward/record.url?scp=8544225766&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=8544225766&partnerID=8YFLogxK

M3 - Article

C2 - 9262843

AN - SCOPUS:8544225766

VL - 15

SP - 169

EP - 181

JO - Blood Purification

JF - Blood Purification

SN - 0253-5068

IS - 3

ER -