High-Flux Dialysis: Clinical, Biochemical, and Proteomic Comparison with Low-Flux Dialysis and On-Line Hemodiafiltration

Blood Purif. 2017;44(2):129-139. doi: 10.1159/000476053. Epub 2017 Jun 2.

Abstract

Hemodiafiltration on-line (on-line HDF) is a more efficient treatment than low-flux hemodialysis (HD). Unfortunately, it cannot be proposed to all patients. The aim of this study was to evaluate the safety, efficiency, and mechanisms of removal of toxins with high-flux HD vs. low-flux HD and on-line HDF. Randomized cross-over study designed to evaluate efficiency and tolerability of high-flux HD vs. low-flux HD in aged patients; to compare by means of biochemical and proteomic analyses the efficiency and mechanisms of removal of toxins with high-flux HD vs. on-line HDF. The removal of small toxins was similar with high-flux and low-flux HD. β2-microglobulin was removed only with high-flux HD, which had an excellent tolerability. The efficiency of high-flux HD was similar to on-line HDF. Proteomic analysis demonstrated that only high-flux membranes remove and adsorb small proteins. High-flux HD may be an efficient alternative to on-line HDF.

Keywords: Hemodialysis safety and efficiency; High-flux dialysis; Low-flux dialysis; On-line hemodiafiltration; Proteomics.

Publication types

  • Comparative Study
  • Randomized Controlled Trial

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Cross-Over Studies
  • Female
  • Hemodiafiltration / adverse effects
  • Hemodiafiltration / instrumentation
  • Hemodiafiltration / methods*
  • Humans
  • Kidney Failure, Chronic / blood
  • Kidney Failure, Chronic / therapy
  • Male
  • Membranes, Artificial
  • Middle Aged
  • Proteomics
  • Renal Dialysis / adverse effects
  • Renal Dialysis / instrumentation
  • Renal Dialysis / methods*
  • beta 2-Microglobulin / blood
  • beta 2-Microglobulin / isolation & purification

Substances

  • Membranes, Artificial
  • beta 2-Microglobulin