Abstract: SA-PO408
Combined Hemodialysis or Hemodiafiltration With Hemoperfusion Treatment for Removal of Uremic Toxins
Session Information
- Hemodialysis and Frequent Dialysis: Clearance, Technology, Infection
November 05, 2022 | Location: Exhibit Hall, Orange County Convention Center‚ West Building
Abstract Time: 10:00 AM - 12:00 PM
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.