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Abstract: SA-OR072

Online Haemodiafiltration Improves Inflammatory State in Dialysis Patients: A Longitudinal Study

Session Information

Category: Dialysis

  • 701 Dialysis: Hemodialysis and Frequent Dialysis

Authors

  • Bhalla, Anil, Sir Ganga Ram Hospital , New Delhi, New Delhi, India
  • Dhanuka, Ganesh, Sir Ganga Ram Hospital , New Delhi, New Delhi, India
  • Gupta, Ashwani, Sir Ganga Ram Hospital , New Delhi, New Delhi, India
  • Shingada, Aakash, Sir Ganga Ram Hospital , New Delhi, New Delhi, India
  • Gaur, Lovy, Sir Ganga Ram Hospital , New Delhi, New Delhi, India
  • Gupta, Anurag, Sir Ganga Ram Hospital , New Delhi, New Delhi, India
  • Bhargava, Vinant, Sir Ganga Ram Hospital , New Delhi, New Delhi, India
  • Joshi, Anant, Sir Ganga Ram Hospital , New Delhi, New Delhi, India
  • Rana, Devinder S., Sir Ganga Ram Hospital , New Delhi, New Delhi, India
Background

We conducted this study to evaluate and compare the effect of online haemodiafiltration(OL-HDF) and conventional haemodialysis(C-HD) on the level of inflammatory markers (hs-CRP,IL1 ,IL6 and TNF- α) in Chronic Kidney Disease V (D).

Methods

In this prospective observational study we measured levels of hs-CRP, IL-1, IL-6 and TNF-alpha at baseline, 3months and 6 months. 60 patients (5 excluded, underwent transplant) with CKD V on C-HD for minimum 3 months were included. Study population was divided in two groups; 27 patients were continued on C-HD; 28 patients shifted on OL-HDF. Follow-up period was 6 months after randomization.

Results

Mean age was 50.22yrs. Mean Kt/v and dry weight were similar in both groups at baseline. Kt/v (P=0.78) & dry weight (P=0.591) remained stable in both groups after 6 months. Mean hs-CRP levels were similar in both groups at baseline (2.66±1.86 mg/dl vs 2.60±1.96 mg/dl; p=0.916) and at 6 months, there was significant reduction of hsCRP in the HDF group by 33%(p-0.007). Mean IL-1 levels were similar at baseline in both groups (177.30±41.86pg/ml vs 166.57±30.29pg/ml; p=0.280) and at 6 months, IL- 1 levels in HDF group decreased significantly (p<0.001) by 13 %. Mean IL-6 levels were similar at baseline in both groups (14.18±9.46pg/ml vs 12.74±7.63pg/ml; p=0.536) and at 6 months IL-6 levels in HDF group decreased significantly (p=0.001) by 33%. Mean TNF-α levels were similar at baseline in both groups (15.47±7.60pg/ml vs 14.87±7.48pg/ml; p=0.771) and at 6 months, TNF-α levels in HDF group decreased significantly (p=0.017) by 22 %. Mean Haemoglobin was similar in both groups at baseline (8.90±1.50gm/dl vs 9.16±1.33 gm/dl; p=0.498). At 6 months, haemoglobin was stable in HD group(p=0.426), while in HDF group it increased significantly (p=0.001) to 10.05±1.53gm/dl. This was associated with a significant decrease on rhEPO requirement in HDF group by 14% (p – 0.043). Mean S. phosphorous was similar in both groups at baseline (6.12±1.72mg/dl vs 6.07±2.05mg/dl; p=0.923). At the end of 6 month reduction in phosphorous in HDF group was significantly higher (p<0.001).

Conclusion

This study showed that CKD related inflammation improved significantly with online-HDF, with significantly decreased level of hs-CRP : 33% , IL-1 : 13% , IL-6 : 33% , THF- α : 22% after 6 months.