Comparison of the effects of pre-dilution and post-dilution online hemodiafiltration on the levels of inflammatory markers, lymphocytes, and platelets. 2022

Yoshitaka Kurihara, and Hiromi Hosoya, and Ruka Kishihara, and Minami Yoshinaga, and Yoshiko Iwadate, and Fumi Yamauchi, and Takeshi Saito, and Kenji Sakurai
Hashimoto Clinic, 3-21-5, Hashimoto, Midori-ku, Sagamihara, Kanagawa, Japan. gishi-y.k@hashicli.jp.

Online hemodiafiltration (OL-HDF) is a blood purification therapy based on diffusion and ultrafiltration and is classified into two types according to the mode of addition of the substitution fluid: pre-dilution OL-HDF (pre-HDF) and post-dilution OL-HDF (post-HDF); we previously reported that pre-HDF is more biocompatible. However, we used lower blood and substitution flow rates in that study and may not have accurately simulated the treatment conditions used in Europe. In this study, we compared the biocompatibilities of the treatment conditions of pre-HDF, commonly used in Japan, and post-HDF, commonly used in Europe, to determine the most biocompatible treatment conditions. We compared the biocompatibilities of pre-HDF and post-HDF using high blood flow rates and high substitution fluid volumes, and also compared the results with those of our previous study. We enrolled six stable patients undergoing maintenance dialysis at our clinic for this study. After the patients underwent hemodialysis (HD), post-HDF, and pre-HDF treatment, the biocompatibilities (based on the serum levels of high-sensitivity C-reactive protein, interleukin-6, pentraxin-3, β-thromboglobulin, and soluble P-selectin, and the results of the lymphocyte blastogenesis test using phytohemagglutinin and concanavalin A as mitogens) and removal performances (removal performance for urea, creatinine, β2-microglubulin [MG], and α1-MG, and albumin leakage) were determined. There were no significant differences in the biocompatibility parameters evaluated among the three treatment modes. Post-HDF was associated with significantly higher removal rates of β2-MG than HD. Post-HDF was associated with significantly higher removal rate of α1-MG, and also significantly higher albumin leakage, than HD and pre-HDF.

UI MeSH Term Description Entries
D007676 Kidney Failure, Chronic The end-stage of CHRONIC RENAL INSUFFICIENCY. It is characterized by the severe irreversible kidney damage (as measured by the level of PROTEINURIA) and the reduction in GLOMERULAR FILTRATION RATE to less than 15 ml per min (Kidney Foundation: Kidney Disease Outcome Quality Initiative, 2002). These patients generally require HEMODIALYSIS or KIDNEY TRANSPLANTATION. ESRD,End-Stage Renal Disease,Renal Disease, End-Stage,Renal Failure, Chronic,Renal Failure, End-Stage,Chronic Kidney Failure,End-Stage Kidney Disease,Chronic Renal Failure,Disease, End-Stage Kidney,Disease, End-Stage Renal,End Stage Kidney Disease,End Stage Renal Disease,End-Stage Renal Failure,Kidney Disease, End-Stage,Renal Disease, End Stage,Renal Failure, End Stage
D008214 Lymphocytes White blood cells formed in the body's lymphoid tissue. The nucleus is round or ovoid with coarse, irregularly clumped chromatin while the cytoplasm is typically pale blue with azurophilic (if any) granules. Most lymphocytes can be classified as either T or B (with subpopulations of each), or NATURAL KILLER CELLS. Lymphoid Cells,Cell, Lymphoid,Cells, Lymphoid,Lymphocyte,Lymphoid Cell
D001792 Blood Platelets Non-nucleated disk-shaped cells formed in the megakaryocyte and found in the blood of all mammals. They are mainly involved in blood coagulation. Platelets,Thrombocytes,Blood Platelet,Platelet,Platelet, Blood,Platelets, Blood,Thrombocyte
D006435 Renal Dialysis Therapy for the insufficient cleansing of the BLOOD by the kidneys based on dialysis and including hemodialysis, PERITONEAL DIALYSIS, and HEMODIAFILTRATION. Dialysis, Extracorporeal,Dialysis, Renal,Extracorporeal Dialysis,Hemodialysis,Dialyses, Extracorporeal,Dialyses, Renal,Extracorporeal Dialyses,Hemodialyses,Renal Dialyses
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D015314 Dialysis Solutions Solutions prepared for exchange across a semipermeable membrane of solutes below a molecular size determined by the cutoff threshold of the membrane material. Dialysate,Dialysis Solution,Dialyzate,Dialysates,Dialyzates,Solution, Dialysis,Solutions, Dialysis
D017583 Hemodiafiltration The combination of hemodialysis and hemofiltration either simultaneously or sequentially. Convective transport (hemofiltration) may be better for removal of larger molecular weight substances and diffusive transport (hemodialysis) for smaller molecular weight solutes. Acetate-Free Biofiltration,Biofiltration, Acetate-Free,Acetate Free Biofiltration,Acetate-Free Biofiltrations,Biofiltration, Acetate Free,Biofiltrations, Acetate-Free

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