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KMID : 0359920080270010062
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Korean Journal of Nephrology
2008 Volume.27 No. 1 p.62 ~ p.69
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The Changes of Clinical Markers, beta2-microglobulin and Oxidized LDL, after Converting to On-line Hemodiafiltration from High-flux Hemodialysis
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Shin Jun-Am
Jang Eun-Hee
Baek Hyun-Jeong
Choi So-Yeon
Kim Min-Ok
Lee Jung-Eun
Huh Woo-Sung
Kim Dae-Joong
Oh Ha-Young
Kim Yoon-Goo
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Abstract
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Purpose: Hemodiafiltration with the on-line regeneration of ultrafiltrate (on-line hemodiafiltration, OLHDF) 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.
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KEYWORD
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Hemodiafiltration, Beta 2-microglobulin, Oxidized LDL
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