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Abstract: SA-PO408

Combined Hemodialysis or Hemodiafiltration With Hemoperfusion Treatment for Removal of Uremic Toxins

Session Information

Category: Dialysis

  • 701 Dialysis: Hemodialysis and Frequent Dialysis

Authors

  • Chalkia, Aglaia, Nephrology Department, Hippokration General Hospital, Athens, Greece
  • Kourniotis, Dimitris, Nephrology Department, Hippokration General Hospital, Athens, Greece
  • Alexakou, Zoi, Nephrology Department, Hippokration General Hospital, Athens, Greece
  • Mpora, Margarita, Nephrology Department, Hippokration General Hospital, Athens, Greece
  • Stambolliu, Emelina, Nephrology Department, Hippokration General Hospital, Athens, Greece
  • Kapota, Athanasia, Nephrology Department, Hippokration General Hospital, Athens, Greece
  • Petras, Dimitrios I., Nephrology Department, Hippokration General Hospital, Athens, Greece
Background

The combination of hemodialysis-hemoperfusion (HDHP) has been proved to be superior to hemodialysis (HD) in eliminating uremic toxins. The optimal prescription is not fully elucidated.

Methods

28 patients with end-stage renal disease were divided into 3 groups. We prescribed in group A hemodialysis (HD) and hemoperfusion (HP) sessions (HDHP), group B only HD and group C hemodiafiltration (HDF) and HP sessions (HDFHP). The reduction ratio (RR) of targeted uremic toxins (low and medium) for each session was assessed. We used the HA-130 adsorption cartridge.

Results

The patients presented median age 71±12 years and median time on HD 12±2 months. We prescribed the HP session once biweekly (for the 1st month) and once monthly (for 11 months) during the first 2H of a regular HD or HDF. After 12 months of this intervention, both HDHP (n=12) and HDFHP (n=8) showed a significant removal of small water-soluble solutes, like urea (HDHP PR 37±1, p=0.03; HDFHP 25±6, p=0.034), compared to HD (n=8) (PR 1±0.5, p=0.09). Regarding middle-sized molecules, HDHP and HDFHP also showed a significant increase in removal of β2-microglubulin (HDHP PR 6±0.7, p=0.023; HDFHP 16.7±0.2, p=0.037) but not for iPTH, compared to HD (PR 1.2±0.7, p=0.098). As far as safety, we only reported low intradialytic blood pressure at 5% of the patients to whom HP was added.

Conclusion

We demonstrated that a combination of hemodialysis or hemodiafiltration and hemoperfusion for 12 months helped efficaciously to reduce low and middle uremic toxins.