Background/Aim: In this study, we compared the dialysis efficiency, oxidative stress, and nutritional conditions between predilution on-line hemodiafiltration (pre-OL-HDF) and conventional hemodialysis (HD) using a super-flux dialyzer (CHD). Method: This was a crossover study of 38 maintenance HD patients. All patients were treated with CHD for the first 4 months (1st CHD period), then were switched to pre-OL-HDF for 4 months (pre-OL-HDF period), and were returned to CHD for the next 4 months (2nd CHD period). Results: We found no significant difference in the removal ratio of small uremic substances or the indices of inflammation or nutritional states between the pre-OL-HDF and CHD periods. However, we found higher removal of β2 micro-globulin in the pre-OL-HDF period, and the human mercapto-albumin (Alb)/human serum Alb ratio was significantly higher in the pre-OL-HDF period. Conclusion: Treatment with pre-OL-HDF enabled enhanced removal of middle molecule uremic toxins and better Alb redox than did CHD.

Journal Section:
Research Article
Keywords:
Predilution on-line hemodiafiltration, Oxidative stress, Inflammation, Nutrition, Human mercapto albumin ratio
1.
Locatelli F, Altieri P, Andrulli S, Bolasco P, Sau G, Pedrini LA, Basile C, David S, Feriani M, Montagna G, Di Iorio BR, Memoli B, Cravero R, Battaglia G, Zoccali C: Hemofiltration and hemodiafiltration reduce intradialytic hypotension in ESRD. J Am Soc Nephrol 2010; 10: 1798–1807.
2.
Akoglu H, Dede F, Piskinpasa S, Falay MY, Odabas AR: Impact of low- or high-flux haemodialysis and online haemodiafiltration on inflammatory markers and lipid profile in chronic haemodialysis patients. Blood Purif 2013; 35: 258–264.
3.
Molina P, Vizcaíno B, Molina M, Beltrán S, González-Moya M, Mora A, Castro-Alonso C, Kanter J, Ávila AI, Górriz JL, Estañ N, Pallardó LM, Fouque D, Carrero JJ: The effect of high-volume online haemodiafiltration on nutritional status and body composition: the ProtEin Stores prEservaTion (PESET) study. Nephrol Dial Transplant 2018; 33: 1223–1235.
4.
Canaud B, Morena M, Leray-Moragues H, Chalabi L, Cristol JP: Overview of clinical studies in hemodiafiltration: what do we need now? Hemodial Int 2006; 10(suppl 1):s5–s12.
5.
Grooteman MP, van den Dorpel MA, Bots ML, Penne EL, van der Weerd NC, Mazairac AH, den Hoedt CH, van der Tweel I, Levesque R, Nube MJ, ter Wee PM, Blankestijn PJ; CONTRAST Investigators: Effect of online hemodiafiltration on all-cause mortality and cardiovascular outcomes. J Am Soc Nephrol 2012; 23: 1087–1096.
6.
Maduell F, Moreso F, Pons M, Ramos R, Mora-Macià J, Carreras J, Soler J, Torres F, Campistol JM, Martinez-Castelao A; ESHOL Study Group: High-efficiency postdilution online hemodiafiltration reduces all-cause mortality in hemodialysis patients. J Am Soc Nephrol 2013; 24: 487–497.
7.
Masakane I, Kikuchi K, Kawanishi H: Evidence for the clinical advantages of predilution on-line hemodiafiltration. Contrib Nephrol 2017; 189: 17–23.
8.
Tomida M, Ishimaru J, Hayashi T, Nakamura K, Murayama K, Era S: The redox states of serum and synovial fluid of patients with temporomandibular joint disorders. Jpn J Physiol 2003; 53: 351–355
9.
Sogami M, Nagoka S, Era S, Honda M, Noguchi K: Resolution of mercapt- and nonmercaptalbumin by high-performance liquid chromatography: Int J Pept Protein Res 1984; 24: 96–103.
10.
Mineshima M, Hoshino T, Teraoka S, Agishi T, Ota K: Effects of dilution modality and filtration flow rate on solute removal characteristics in HF and HDF with high ultrafiltration. Jan J Artif Organs 1995; 24: 670–675.
11.
Miyata T, Wada Y, Cai Z, Iida Y, Horie K, Yasuda Y, Maeda K, Kurokawa K, van Ypersele de Strihou C: Implication of an increased oxidative stress in the formation of advanced glycation end products in patients with end-stage renal failure. Kidney Int 1997; 51: 1170–1181.
12.
Canaud B, Cristol J, Morena M, Leray-Moragues H, Bosc J, Vaussenat F: Imbalance of oxidants and antioxidants in haemodialysis patients. Blood Purif 1999; 17: 99–106.
13.
Sakurai K, Saito T, Yamauchi F, Asahi D, Hosoya H: Comparison of the effects of predilution and postdilution hemodiafiltration on neutrophils, lymphocytes and platelets. J Artif Organs 2013; 16: 316–321.
14.
Tomo T, Matsuyama K, Nasu M: Effect of hemodiafiltration against radical stress in the course of blood purification. Blood Purif 2004; 22(suppl 2): 72–77.
15.
Liakopoulos V, Roumeliotis S, Gorny X, Dounousi E, Mertens PR: Oxidative stress in hemodialysis patients: a review of the literature. Oxid Med Cell Longev 2017: 3081856.
16.
Vanholder R1, De Smet R, Glorieux G, Argilés A, Baurmeister U, Brunet P, Clark W, Cohen G, De Deyn PP, Deppisch R, Descamps-Latscha B, Henle T, Jörres A, Lemke HD, Massy ZA, Passlick-Deetjen J, Rodriguez M, Stegmayr B, Stenvinkel P, Tetta C, Wanner C, Zidek W; European Uremic Toxin Work Group (EUTox): Review on uremic toxins: classification, concentration, and interindividual variability. Kidney Int 2003; 63: 1934–1943.
17.
Kuragano T, Kida A, Furuta M, Nanami M, Otaki Y, Hasuike Y, Nonoguchi H, Nakanishi T. The impact of beta2-microglobulin clearance on the risk factors of cardiovascular disease in hemodialysis patients. ASAIO J 2010; 56: 326–332.
18.
Okuno S, Ishimura E, Kohno K, Fujino-Katoh Y, Maeno Y, Yamakawa T, Inaba M, Nishizawa Y: Serum beta2-microglobulin level is a significant predictor of mortality in maintenance haemodialysis patients. Nephrol Dial Transplant 2009; 24: 571–577.
19.
Lim PS, Jeng Y, Wu MY, Pai MA, Wu TK, Liu CS, Chen CH, Kuo YC, Chien SW, Chen HP: Serum oxidized albumin and cardiovascular mortality in normoalbuminemic hemodialysis patients: a cohort study. PLoS One 2013; 8:e70822.
© 2019 S. Karger AG, Basel
Copyright / Drug Dosage / Disclaimer
Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.
2019
You do not currently have access to this content.