Expanded Hemodialysis as an Alternative to Suboptimal Online Hemodiafiltration.

IF 2.2 3区医学 Q3 HEMATOLOGY

Blood Purification Pub Date : 2026-01-01 Epub Date: 2026-01-19 DOI:10.1159/000550038

Martín Giorgi, Ana Sánchez-Horrillo, María Riutort-Garvi, Jesús Bonilla-Rico, Melissa Liriano-Alba, Daniela Abzueta, Ignacio Gómez-Rojas, Aranzazu Alfranca, Eva Sanjuán-Suria, Marta Fernández-Sampedro, Natalia F Pascual Gómez, María A Bajo, Borja Quiroga

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引用次数: 0

Abstract

Introduction: Online hemodiafiltration (OLHDF) is associated to reduction in cardiovascular events and mortality when achieving high-dose convective volume. However, not all patients are able to reach the optimal volume of OLHDF or are not eligible for OLHDF. The aim of the present study was to compare expanded hemodialysis (HDx) and suboptimal post-dilution OLHDF in the reduction of solutes.

Methods: In this observational prospective study, we included all the patients of our hemodialysis units with suboptimal (i.e., convective volume <19.2 L) OLHDF. After a minimum of 1 month in OLHDF, patients were switched to HDx for another month. Removal ratio (RR) for small, medium, and large molecules was calculated for each period. In addition, we compared the global removal score (GRS) with both techniques.

Results: Twelve patients were included (58% male, 68 ± 16 years) and completed the study. OLHDF displayed higher RR of urea (p = 0.011), prolactin (p < 0.001), β2-microbloglulin (p = 0.011), myoglobin (p = 0.015), kappa free light chains (FLCs) (p = 0.04), and lambda FLC (p = 0.012). In contrast, OLHDF and HDx presented similar RR of creatinine, C-reactive protein, albumin, α2-macroglobulin, interleukin (IL)-1, IL-6, IL-8, IL-10, IL12, TNF-α, metalloproteinase-1, and p-cresol. The GRS was similar in OLHDF and HDx (55 [46-70]% vs. 51 [41-59]%, NS).

Conclusion: HDx presents a similar GRS in comparison to OLHDF demonstrating that this technique can be prescribed in cases of suboptimal convective volume achievement.

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扩大血液透析作为次优在线血液滤过的替代方法。

在线血液滤过（OLHDF）与达到高剂量对流容积时心血管事件和死亡率的降低有关。然而，并非所有患者都能达到最佳的OLHDF量或不符合OLHDF的条件。本研究的目的是比较扩大血液透析（HDx）和次优稀释后的OLHDF在减少溶质方面的作用。方法：在这项观察性前瞻性研究中，我们纳入了我们血液透析单位的所有次优（即对流容积）患者。结果：12例患者（58%男性，68±16岁）完成了研究。OLHDF显示出更高的尿素（p=0.011）、催乳素(p)的RR值。结论：HDx与OLHDF具有相似的RR值，表明该技术可用于对流容积达到次优的情况。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Blood Purification 医学-泌尿学与肾脏学

CiteScore

5.80

自引率

3.30%

发文量

审稿时长

6-12 weeks

期刊介绍： Practical information on hemodialysis, hemofiltration, peritoneal dialysis and apheresis is featured in this journal. Recognizing the critical importance of equipment and procedures, particular emphasis has been placed on reports, drawn from a wide range of fields, describing technical advances and improvements in methodology. Papers reflect the search for cost-effective solutions which increase not only patient survival but also patient comfort and disease improvement through prevention or correction of undesirable effects. Advances in vascular access and blood anticoagulation, problems associated with exposure of blood to foreign surfaces and acute-care nephrology, including continuous therapies, also receive attention. Nephrologists, internists, intensivists and hospital staff involved in dialysis, apheresis and immunoadsorption for acute and chronic solid organ failure will find this journal useful and informative. ''Blood Purification'' also serves as a platform for multidisciplinary experiences involving nephrologists, cardiologists and critical care physicians in order to expand the level of interaction between different disciplines and specialities.