Abstract: SA-PO900
A Global Study Assessing Albumin Levels on Expanded Hemodialysis
Session Information
- Dialysis: Cardiovascular, BP, Volume
October 27, 2018 | Location: Exhibit Hall, San Diego Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Dialysis
- 701 Dialysis: Hemodialysis and Frequent Dialysis
Authors
- Hutchison, Colin A., Hawke's Bay DHB, Hastings, New Zealand
- Dorval, Marc, Dr. Georges-L.-Dumont University Hospital Centre, Moncton, New Brunswick, Canada
- Canziani, Maria Eugenia F., Federal University of Sao Paulo, Sao Paulo, Brazil
- Belmouaz, Mohamed, Service Nephrologie, Poitiers, France
- Baharani, Jyoti B., Heart of England Foundation Trust, Birmingham, United Kingdom
- Ronco, Claudio, Ospedale "S. Bortolo" AZ. ULSS 6, Vicenza, Italy
Background
Expanded hemodialysis (expHD) utilises a new form of hemodialysis membranes which enable more effective removal of middle and large molecular weight uremic toxins. These medium cut-off (MCO) membranes have pores which are significantly larger and more uniform than conventional high flux dialysis membranes but have the potential to allow some albumin leak. The purpose of this study was to assess expHD’s effect on patients’ pre-dialysis serum albumin levels over 6 months.
Methods
Patients receiving expHD were identified from dialysis centres in North and South America, Europe and Australasia. Details of basic demographics, dialysis prescription, laboratory parameters and recombinant erythropoietin dose were captured retrospectively.
Results
Data was available for 56 patients from 5 centres in Brazil, Canada, France, Italy, New Zealand and the United Kingdom. Median age was 67 years (range 23-91), 69% were male, 41% were diabetic, average time on hemodialysis was 55 months (10-215); median dry weight was 76 kg (44-124). 55% received dialysis on the larger MCO membrane dialyzer (Theranova 500 ©). Average dialysis prescription was: 4 hours (range 4-5.5) with Qb 300 ml/min (250-400) delivering an average Kt/V of 1.4 (1-2.5). Pre-dialysis serum albumin levels over the study period are presented in the table. No significant changes in albumin levels at 3 or 6 months from baseline are observed, p=0.42 and 0.66 respectively. CRP and haemoglobin levels were 4 mg/L (1.5-16) and 11 g/dL (8.2-14.2) pre-MCO use and 6 (1.5-25) and 11.3 (8.1-13) at 6 months respectively. Recombinant erythropoeitin dose increased in 15%, remained the same in 35% and decreased in 50% of participants over the observation period.
Conclusion
ExpHD did not result in any significant change in pre-dialysis serum albumin concentrations over 6 months treatment. Over this observation period, inflammatory markers and haemoglobin levels were stable but of potential interest 50% of the population had a reduction in erythropoietin dose.
Serum albumin levels
| Serum albumin (g/dL) | ||||
| Pre-MCO | 1 month | 3 months | 6 months | |
| Median | 3.7 | 3.5 | 3.6 | 3.7 |
| Min | 2.8 | 2.8 | 2.9 | 2.8 |
| Max | 4.5 | 4.6 | 4.5 | 5.1 |