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Kidney Week

Abstract: PO1211

Effects of Combined Expanded Hemodialysis (HDx) and Hemoadsorption (HA) in Hemodialysis (HD) Patients: A Single Center's Experience

Session Information

Category: Dialysis

  • 701 Dialysis: Hemodialysis and Frequent Dialysis

Authors

  • Damianaki, Katerina, Nephrology Department, Hippokration General Hospital, Athens, Greece
  • Kourniotis, Dimitris, Nephrology Department, Hippokration General Hospital, Athens, Greece
  • Alexakou, Zoe, Nephrology Department, Hippokration General Hospital, Athens, Greece
  • Mpora, Margarita, Nephrology Department, Hippokration General Hospital, Athens, Greece
  • Giannou, Panagiota E., Nephrology Department, Hippokration General Hospital, Athens, Greece
  • Petras, Dimitrios I., Nephrology Department, Hippokration General Hospital, Athens, Greece
Background

HDx appears to achieve a better removal performance of middle and large molecules due to the cut-off pores and the internal architecture of the membranes while recent studies have indicated the effective role of HA in reducing uremic symptoms in HD patients. The aim of our study was to assess the impact of the appliance of these two new modalities on several clinical parameters in chronic HD.

Methods

15 HD patients (mean age=53.5 years, BMI= 26.5 kg/m2, years on dialysis=5.5) were included. All subjects were already treated with HDx (Baxter Theranova) for 6 months. After this period, patients received combined HDx with HA (Jafron HA-130) weekly for 4 weeks and an additional combined treatment in week 12. The HA was applied in the middle-week day session for 2.5 hours. No change in their current medication was done during this period of time. Serum biomarkers were measured at baseline, at week 1, 12 and 16 (follow-up period) and included measurement of hemoglobin, platelet count, white blood cells, albumin, lipids, calcium, phosphorus, β2-microglobulin and Parathormone levels. Monthly kt/v was calculated appropriately.

Results

No statistically significantly differences were observed before and after the appliance of the combined treatment in respect of hemoglobin, white blood cells, platelets, phosphorus, Parathormone, HDL, triglycerides, albumin levels and the dialysis efficiency expressed by the monthly kt/v. However, a statistically significantly decrease of calcium levels were found between baseline levels and levels measured at the follow-up period (9.08±0.77mg/dl vs 8.37±0.66 mg/dl, p=0.005). Furthermore, LDL levels appeared to show a statistically significantly decrease until week 12 (110.33±28.99 mg/dl vs 103.00±27.19 mg/dl, p=0.048) and then a statistically significantly increase at the follow-up period (103.00±27.19 mg/dl vs 109.83±30.60 mg/dl, p=0.030). No adverse events were reported.

Conclusion

A combination of HDx and HA seems to show a potential effect in modifying lipid abnormalities in dialysis patients. These results can improve the outcome, especially in cardiovascular disease patients. However, the frequency of applying sorbent-based therapies for maintaining the desired results, needs to be evaluated and standardized in larger studies.