In:
Blood Purification, S. Karger AG, Vol. 22, No. Suppl. 2 ( 2004), p. 14-19
Abstract:
Daily hemofiltration (D-HF) is a new treatment modality that shows unique solute removal characteristics and possibly provides high quality of life for patients with end-stage renal disease. We evaluated solute removal characteristics of D-HF for 5 patients by kinetic modeling analysis. Five patients treated with normal 4-hour × 3 times/week hemodialysis (HD) were switched to D-HF (2-hour × 6 times/week). Ultrafiltration rates 〈 i 〉 (Q 〈 sub 〉 F 〈 /sub 〉 ) 〈 /i 〉 or small solute clearances ranged from 63 to 106 ml/min. All the pertinent kinetic parameters were determined from patients’ physical data and the HD portion of the clinical measurements. The two-compartment kinetic model predicted the concentration changes after switching from normal HD to D-HF. In all 5 patients, concentrations of small solutes such as urea-nitrogen (UN) increased whereas that of β 〈 sub 〉 2 〈 /sub 〉 -microglobulin (β 〈 sub 〉 2 〈 /sub 〉 -MG) decreased after switching from normal HD to D-HF. Predicted solute concentrations and clinical measurements for UN and β 〈 sub 〉 2 〈 /sub 〉 -MG were in good agreement with average error less than 10%. The model predicted that 〈 i 〉 Q 〈 sub 〉 F 〈 /sub 〉 〈 /i 〉 = 155 ml/min may be necessary for the time-averaged concentration 〈 i 〉 (TAC) 〈 /i 〉 of UN to be unchanged. The model also predicted that the 7 times/week D-HF should not increase the pretreatment concentration of UN, expecting even much lower β 〈 sub 〉 2 〈 /sub 〉 -MG concentration after switching from normal HD to D-HF. D-HF is superior to normal HD for removing larger solutes but may increase the 〈 i 〉 TAC 〈 /i 〉 of small solutes. A 7-day treatment (7 times/week) D-HF may improve the solute removal capacity of small solutes.
Type of Medium:
Online Resource
ISSN:
0253-5068
,
1421-9735
Language:
English
Publisher:
S. Karger AG
Publication Date:
2004
detail.hit.zdb_id:
1482025-0
