Abstract: TH-PO786

Phosphate Removal in Maintenance Hemodialysis with Different Dialysis Modality and Different Dialyzer

Session Information

Category: Dialysis

  • 607 Dialysis: Epidemiology, Outcomes, Clinical Trials - Non-Cardiovascular

Authors

  • Luo, Jing, Nanjing Medical University, Nanjing, China
  • Fang, Li, Nanjing Medical University, Nanjing, China
  • Ye, Hong, Second Affiliated Hospital, Nanjing Medical University, Nanjing, China
  • Yang, Junwei, Second Affiliated Hospital, Nanjing Medical University, Nanjing, China
Background

Hyperphosphatemia is one of the most common complications of maintenance hemodialysis (MHD) patients, and the association with an increased risk of mortality has been demonstrated. The normalization of phosphate plasma levels is therefore an important goal in the treatment of MHD patients. Accordingly, to assess phosphate removal by hemodialysis (HD) is important to improve phosphate control in patients on maintenance HD.

Methods

48 MHD patients enrolled in this study underwent three period: one week HD with B3-1.6a (Toray, 1.6m2, low-flux) (period 1) , then one week HD with TS-1.6SL (Toray, 1.6m2, high-flux) (period 2) and switched to another week hemodiafiltration (HDF) with TS-1.6SL (period 3). Each study period was separated by a washout of 2 weeks. Blood samples were collected at 0 min, 30 min, 60 min, 120 min, 180 min, 240 min after the start of dialysis and 60 min postdialysis. Effluent dialysate samples were collected every 15 min during the 4-hour HD treatment to measure the phosphate removal. Predialysis levels of serum phosphate, potassium, hematocrit, intact parathyroid hormone, alkaline phosphatase Echocardiogram, clinical and dialysis characteristics were obtained.

Results

The reduction of phosphate concentration of blood in dialysis process were 34.74%±6.01%, 48.10%±6.62%, 60.76%±6.98%, 63.81%±7.35%, 63.07%±7.93% at 30 min, 60 min, 120 min, 180 min, 240 min point respectively and returned to 52.41%±9.18% at 60 min postdialysis. There were statistical differences in the period 1, period 2 and period 3 at 30min point (29,79%±3.79%, 36.79%±6.82% and 36.64%±3.95%, P=0.000), 60min point (43.36%±4.94%, 49.86%±6.87% and 51.07%±5.44%, P=0.002) , 120 min point (56.14%±6.36%, 62.86%±6.27% and 63.29%±6.28%, P=0.007). Total amount of phosphate removal within the 4-hour HD was mostly 25.54±5.77 mmol during per four-hour treatment. The first hour of treatment removed 39.85%±3.99% of the total mass, and 24.41%±1.67%, 18.34%±1.94%, 17.32%±3.00% at the second, the third and the forth hour respectively. However, no statistical differences were found in the three periods.

Conclusion

The maximum reduction of blood phosphate concentration was about 60% at 120 min point, and rised again postdialysis. The reduction of blood phosphate concentration was higher with HDF or with high-flux dialyzer.

Funding

  • Government Support - Non-U.S.