ASN's Mission

ASN leads the fight to prevent, treat, and cure kidney diseases throughout the world by educating health professionals and scientists, advancing research and innovation, communicating new knowledge, and advocating for the highest quality care for patients.

learn more

Contact ASN

1401 H St, NW, Ste 900, Washington, DC 20005

email@asn-online.org

202-640-4660

The Latest on Twitter

Kidney Week

Abstract: PO0845

Neurocognitive Function with Conventional Hemodialysis vs. Post-Dilution Hemofiltration as Initial Treatment: A Randomized Controlled Trial (The DA-VINCI Study)

Session Information

Category: Dialysis

  • 701 Dialysis: Hemodialysis and Frequent Dialysis

Authors

  • Vasquez jiménez, Enzo Christopher, Instituto Nacional de Cardiologia Ignacio Chavez, Mexico, Mexico, Mexico
  • Núñez, María Guadalupe Campos, Instituto Nacional de Cardiologia Ignacio Chavez, Mexico, Mexico, Mexico
  • Gil, Salvador Lopez, Instituto Nacional de Cardiologia Ignacio Chavez, Mexico, Mexico, Mexico
  • Lerma Talamantes, Abel V., Universidad Autonoma del Estado de Hidalgo Instituto de Ciencias de la Salud, Pachuca, Hidalgo, Mexico
  • Lerma Gonzalez, Claudia V., Instituto Nacional de Cardiologia Ignacio Chavez, Mexico, Mexico, Mexico
  • Meave Gonzalez, Aloha V., Instituto Nacional de Cardiologia Ignacio Chavez, Mexico, Mexico, Mexico
  • Madero, Magdalena, Instituto Nacional de Cardiologia Ignacio Chavez, Mexico, Mexico, Mexico
Background

The ideal modality choice and dialysis prescription during the first renal replacement therapy (RRT) session remains controversial. We conducted a pilot study to determine the safety risk for hemodialysis versus hemofiltration and its relationship with neurocognitive assessment on incident RRT patients.

Methods

Twenty-four incident RRT patients were included. Patients were randomized the conventional HD group or the post-dilution HF group. MMSE and MOCA tests were applied in all patients before and after RRT and brain MRI was performed in 7 patients from each group before and after the intervention.

Results

Baseline characteristics were similar between groups. Compared to conventional HD, post-dilution HF had longer treatment time and blood volume. There were no significant changes in blood pressure after RRT in both groups. The MMSE test showed no significant differences between groups or within groups. The MOCA test showed an increase in the total score for the post dilution HF group with no significant changes between groups. The magnetic resonance image (MRI) evaluation showed no differences between or within groups.

Conclusion

Post-dilution hemofiltration is a safe alternative for the first hemodialysis session in incidence RRT; it allows longer treatment time if ultrafiltration is required has a similar neurological risk than conventional HD.

Hemodialysis and hemodynamic variables.
 Conventional HD
(n = 12)
Conventional HD
(n = 12)
Post dilution HF
(n = 12)
Post dilution HF
(n = 12)
 BeforeAfterBeforeAfter
Body weight (Kg)71.6 ± 18.667.2 ± 28.371.0 ± 17.467.7 ± 14.5
SBP (mmHg)163 ± 29158 ± 28161 ± 30161 ± 21
DBP (mmHg)88 ± 1486 ± 1390 ± 2187 ± 19
BUN (mg/dL)137.3 ± 61.791.1 ± 39.3 *124.5 ± 34.886.4 ± 25.5 *
MMSE test    
Total score
Cognitive impairment
23 ± 3
10 (83%)
26 ± 2
3 (25%)
25 ± 3
2 (17%)
26 ± 2
1 (8%)
MOCA test    
Total score
Cognitive impairment
23 ± 3
10 (83%)
25 ± 5
4 (33%) *
22 ± 4
10 (83%)
25 ± 3 *
6 (50%) *
MRI findings
Silent infarction
Other abnormalities
No abnormalities

5 (42%)
0 (0%)
2 (17%)

5 (42%)
0 (0%)
2 (17%)

7 (58%)
1 (8%)
0 (0%)

7 (58%)
1 (8%)
0 (0%)

Data are shown as mean ± standard deviation, median (percentile 25, percentile 75) or absolute frequency (percentage). * = p ≤ 0.05 compared to before dialysis (within same group)