Factors Associated with Albumin Loss in Post-Dilution Hemodiafiltration and Nutritional Consequences

Introduction Hemodiafiltration is currently one of the most effective techniques of extra-renal purification but results in an increase of albumin loss in dialysate. We aimed to determine the factors associated with albumin loss during post-dilution hemodiafiltration, compare an “automatic” mode of...

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Bibliographic Details
Published in:International journal of artificial organs 2015-02, Vol.38 (2), p.76-82
Main Authors: Fournier, Anne, Birmelé, Béatrice, François, Maud, Prat, Louis, Halimi, Jean-Michel
Format: Article
Language:English
Subjects:
Aged
Albumins
Automatic control
Biomarkers - blood
Correlation
Effluents
Equipment Design
Female
Flow control
France
Hemodiafiltration - adverse effects
Hemodiafiltration - instrumentation
Hemodiafiltration - methods
Humans
Kidney Diseases - blood
Kidney Diseases - diagnosis
Kidney Diseases - therapy
Male
Manual control
Membranes
Membranes, Artificial
Middle Aged
Nutrition Assessment
Nutritional Status
Patients
Prospective Studies
Risk Factors
Serum Albumin - metabolism
Serum Albumin, Human
Treatment Outcome
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Summary:Introduction Hemodiafiltration is currently one of the most effective techniques of extra-renal purification but results in an increase of albumin loss in dialysate. We aimed to determine the factors associated with albumin loss during post-dilution hemodiafiltration, compare an “automatic” mode of infusate flow control versus a “manual” control, and assess the potential nutritional impact. Methods This prospective observational study included all hemodialysis patients in our institution who underwent post-dilution hemodiafiltration 3 times a week on a Fresenius 5008 for at least 2 months. At each session, albumin content was measured in a representative effluent dialysate volume. The automatic mode of the Fresenius 5008 was used for automatic infusate flow control. Results In all, 18 patients (mean age 60.7 ± 15 years) underwent 85 post-dilution hemodiafiltration sessions. The mean albumin loss was 3134 ± 2450 mg/session. Albumin loss was significantly affected by infusate flow, infusate volume, transmembrane pressure and ultrafiltration volume. The loss was greater with Toraysulfone and FX 1000 membranes rather than FX 80 or FX 100 membranes. With AutoSub rather than manual control, infusate flow was greater (P
ISSN:0391-3988
1724-6040
DOI:10.5301/ijao.5000389