The Changes of Clinical Markers, beta2-microglobulin and Oxidized LDL, after Converting to On-line Hemodiafiltration from High-flux Hemodialysis.
- Author:
Jun Am SHIN
1
;
Eun Hee JANG
;
Hyunjeong BAEK
;
So Yeon CHOI
;
Min Ok KIM
;
Jung Eun LEE
;
Wooseong HUH
;
Dae Joong KIM
;
Ha Young OH
;
Yoon Goo KIM
Author Information
1. Department of Internal Medicine, Samsung Medical Center, College of Medicine, Sungkyunkwan University, Seoul, Koera. ygkim26@skku.edu
- Publication Type:Original Article
- Keywords:
Hemodiafiltration;
Beta 2-microglobulin;
Oxidized LDL
- MeSH:
Anemia;
Anorexia;
beta 2-Microglobulin;
Biomarkers;
Erythropoietin;
Fatigue;
Hand;
Hemodiafiltration;
Hemoglobins;
Humans;
Inflammation;
Kidney Failure, Chronic;
Lipoproteins, LDL;
Oxidative Stress;
Plasma;
Pruritus;
Regeneration;
Renal Dialysis;
Sensation;
Sleep Initiation and Maintenance Disorders
- From:Korean Journal of Nephrology
2008;27(1):62-69
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
PURPOSE: Hemodiafiltration with the on-line regeneration of ultrafiltrate (on-line hemodiafiltration, OL- HDF) provides better clearance of both small and large solutes than high-flux hemodialysis (HFHD) and may reduce inflammation and oxidative stress. The purpose of this observational study was to ascertain whether OL-HDF improves clinical markers after switching from HFHD to OL-HDF in patients with end-stage renal disease. METHODS: Fourteen stable patients on HFHD for at least 6 months were switched to OL-HDF. We observed changes in subjective symptoms, the levels of hemoglobin, erythropoietin dose, Kt/V, URR, beta 2-microglobulin, plasma oxidized LDL (OxLDL) and CRP for twelve-months period. RESULTS: There were improvements in subjective symptoms including fatigue, anorexia, insomnia and itching sensation (p<0.05). There were significant increases in Kt/V (1.63+/-0.17 vs. 1.77+/-0.24, p< 0.05) and URR (75.1+/-3.2 vs. 77.2+/-3.9%, p<0.05). Even though erythropoietin dose was not changed, hemoglobin level was increased (10.6+/-1.3 vs. 11.4+/-1.0, p<0.05). Beta 2-microglobulin clearance was significantly increased (17.7+/-4.4 vs. 21.9+/-6.1 mL/min, p<0.05). However, the pre-dialysis level of beta 2-microglobulin was not significantly reduced. The pre-dialysis level of CRP was not changed. OxLDL reduction ratio was not changed. On the other hand, the pre-dialysis plasma level of OxLDL was significantly reduced (32.36+/-6.03 vs. 26.05+/-6.00 U/L, p<0.05). CONCLUSION: OL-HDF improved several subjective symptoms, anemia, the clearance of small solute, beta 2-microglobulin level and reduced plasma OxLDL after switching from HFHD. Less OxLDL may be generated in OL-HDF compared with HFHD.
