Effectiveness of push/pull hemodiafiltration using large-pore membrane for shoulder joint pain in long-term dialysis patients.
Long-term hemodialysis (HD) patients complaining of shoulder joint pain were treated by HD and by push/pull HDF using high-flux synthetic membranes with large pores (Asahi PAN 20CX2) for 2 weeks. The results showed no significant difference in Kt/Vurea between HD and push/pull HDF. Nevertheless, reduction of the plasma beta 2-microglobulin was greater during push/pull HDF than during HD. These findings can be explained by far more convective flux in push/pull HDF than in HD: nearly 30 L during push/pull HDF vs. 3 L during HD. In the present study, there was no alleviation of the shoulder joint pain during HD treatment, whereas marked relief of the symptom was found during push/pull HDF treatment. Since the two treatment modalities differ simply in their efficiency in removing larger molecular weight substances, the joint pain alleviation effected by push/pull HDF could well be ascribed to elimination of an unknown larger molecular weight substance causing this symptom. However, a considerable amount of beta 2-microglobulin was removed both by HD and push/pull HDF. Therefore, the substance causing the joint pain might be larger than beta 2-microglobulin.
Maeda
K
K
Department of Internal Medicine, Nagoya University Branch Hospital, Japan.
Kobayakawa
H
H
Fujita
Y
Y
Takai
I
I
Morita
H
H
Emoto
Y
Y
Miyazaki
T
T
Shinzato
T
T
D005260:Female; D006440:Hemofiltration; D006801:Humans; D008297:Male; D008567:Membranes, Artificial; D008875:Middle Aged; D008970:Molecular Weight; D009068:Movement / Q000502:physiology; D059408:Pain Management; D006435:Renal Dialysis; D012785:Shoulder Joint / Q000502:physiology; D013997:Time Factors; D001613:beta 2-Microglobulin / Q000032:analysis
D008567:Membranes, Artificial; D001613:beta 2-Microglobulin