Online hemodiafiltration: 4 years of clinical experience

Online hemodiafiltration (online HDF) is a new hemodialysis technique combining convection and diffusion and thus also enabling the purification of large molecules. As yet, only a small number of clinical experiences have been published about the effectiveness and safety of online HDF. We present a...

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Bibliographic Details
Published in:Hemodialysis international 2006-01, Vol.10 (s1), p.S28-S32
Main Authors: MUÑOZ, Rosa, GALLARDO, Isabel, VALLADARES, Evandro, SARACHO, Ramón, MARTÍNEZ, Isabel, OCHARAN, Julen, MONTENEGRO, Jesús
Format: Article
Language:English
Subjects:
adequate dialysis
Adult
Aged
Aged, 80 and over
Anemia - etiology
Calcium Phosphates - metabolism
Female
Hemodiafiltration - adverse effects
Hemodiafiltration - instrumentation
Hemodiafiltration - methods
Humans
Hypotension - etiology
Inflammation - etiology
Longitudinal Studies
Male
Middle Aged
Nutritional Physiological Phenomena
Online hemodiafiltration
Online Systems
renal replacement therapy
Treatment Outcome
urea elimination
β2 microglobulin removal
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Summary:Online hemodiafiltration (online HDF) is a new hemodialysis technique combining convection and diffusion and thus also enabling the purification of large molecules. As yet, only a small number of clinical experiences have been published about the effectiveness and safety of online HDF. We present a prospective and observational study conducted on 31 patients treated with online HDF in our center in the last 4 years. The purpose of the study is to compare the evolution of the following aspects before and after starting online HDF: dose of dialysis, purification of medium‐sized/large molecules, inflammation, nutrition, Ca‐P metabolism, anemia, and intradialytic complications. Online HDF increased Kt/V to 31.0% (p>0.001) and reduced postdialysis β2‐M to 66.4% (p>0.001). The rest of the parameters analyzed did not vary significantly. During online HDF, episodes of symptomatic hypotension fell by 45% in relation to conventional hemodialysis, and no relevant complication occurred. Online HDF is very useful in patients in whom we need to increase replacement therapy, such as patients with a large body surface, those in whom we suspect a residual syndrome or those who have been receiving dialysis for a long time and for whom we wish to prevent amyloidosis. Online HDF is safe and better tolerated than conventional hemodialysis.
ISSN:1492-7535
1542-4758
DOI:10.1111/j.1542-4758.2006.01187.x