Predilution haemofiltration—the Second Sardinian Multicentre Study: comparisons between haemofiltration and haemodialysis during identical Kt/V and session times in a long‐term cross‐over study

• Published in: Nephrology, dialysis, transplantation dialysis, transplantation, 2001-06, Vol.16 (6), p.1207-1213
• Main Authors: Altieri, Paolo, Sorba, Giambattista, Bolasco, Piergiorgio, Asproni, Emilio, Ledebo, Ingrid, Cossu, Maria, Ferrara, Rocco, Ganadu, Marino, Cadinu, Franco, Serra, Giovanna, Cabiddu, Gianfranca, Sau, Giovanna, Casu, Domenica, Passaghe, Mario, Bolasco, Ferruccio, Pistis, Raffaele, Ghisu, Tonina
• Format: Article
• Language: English
• Subjects: Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy; Biological and medical sciences; Blood Flow Velocity; Blood Pressure; Blood Pressure Monitoring, Ambulatory; convective treatments; Cross-Over Studies; Depression; Emergency and intensive care: renal failure. Dialysis management; Fatigue; haemofiltration adequacy; Hemofiltration - adverse effects; Hemofiltration - methods; Humans; Hypertension - epidemiology; Hypotension - epidemiology; Intensive care medicine; Kidney Failure, Chronic - physiopathology; Kidney Failure, Chronic - psychology; Kidney Failure, Chronic - therapy; Medical sciences; Middle Aged; on‐line haemofiltration; pre‐dilution haemofiltration; Quality of Life; Renal Dialysis - adverse effects; Renal Dialysis - methods; Time Factors; Treatment Outcome; Urea - blood
• ISSN: 0931-0509; 1460-2385
• DOI: 10.1093/ndt/16.6.1207

Background. The potential superiority of various renal replacement treatment modalities consisting largely of convective mass transfer as opposed to primarily diffusive mass transfer, is still a matter of debate. The objective of the present study was to evaluate acute and long‐term clinical effects of varying degrees of convection and diffusion in a group of 24 clinically stable patients with end‐stage renal disease. Methods. The patients were prospectively assigned to three consecutive treatment schedules of 6 months each: phase I (HF1) (on‐line predilution haemofiltration)→phase II (HD) (high‐flux haemodialysis)→phase III (HF2; as phase I). We used the AK100/200 ULTRA monitor (Gambro), which prepares ultrapure dialysis fluid for HD and sterile, pyrogen‐free substitution solution for HF. The membrane (polyamide), fluid composition, and treatment time were the same on HF and HD. The targeted equilibrated Kt/V was 1.2 for both treatment modes, creating a similar urea clearance. Results. Fifteen patients, mean age 62.8±8.4 years, completed the study according to the above conditions. Urea kinetics, nutritional parameters, and dry weight were similar in the three periods. The frequency of intra‐treatment episodes of hypotension/patient/month was significantly lower on HF1 (1.24) and HF2 (1.27) than on HD (1.80) (P