The effectiveness of on-line hemodiafiltration on beta-2 microglobulin clearance in end stage renal disease

J Med Assoc Thai. 2006 Aug:89 Suppl 2:S1-8.

Abstract

Objective: To compare beta2-microglobulin (beta2M) clearance between on-line hemodiafiltration (HDF) and high flux hemodialysis (HFHD).

Material and method: The total, convection/diffusion, and membrane adsorption components of beta2M clearance in 10 hemodialysis patients treated with on-line HDF at the replacement fluid rates of 75 (HDF75) and 125 (HDF125) mL/min, were determined and compared with HFHD.

Results: The total beta2M clearance in the HDF 125 group was significantly higher than the HDF75 group (124.5 +/- 4.4 vs 101.3 +/- 4.1 mL/min; p < 0.05); both values were much greater than the HFHD group (p < 0.01). The convection/diffusion was the major portion of total beta2M clearance in all three groups. The values of convection/diffusion and membrane adsorption in both HDF groups were about 2 and 3 times, respectively, of the HFHD group (p < 0.01). Both components of beta2M clearance in the HDF125 group did not statistically differ from the HDF75 group, however; the value of convection/diffusion clearance in HDF125 was more than in the HDF75 group. Regarding Kt/Vurea and phosphate clearance, there were no significant differences among the study groups.

Conclusion: On-line HDF could provide more beta2M clearance than HFHD by increasing both the convection/ diffusion, and membrane adsorption clearances. HDF125 provided more total beta2M clearance than HDF75 from the convection/diffusion mechanism while the adsorptive mechanisms were equal.

MeSH terms

  • Analysis of Variance
  • Convection
  • Diffusion
  • Female
  • Hemodiafiltration / methods*
  • Humans
  • Kidney Failure, Chronic / blood
  • Kidney Failure, Chronic / therapy*
  • Male
  • Middle Aged
  • Prospective Studies
  • Treatment Outcome
  • beta 2-Microglobulin / blood*

Substances

  • beta 2-Microglobulin