Recombinant human erythropoietin and high flux haemodiafiltration.
Since 1982, 32 uraemic patients were treated in our institution by high flux haemodiafiltration (H-HDF) in order to shorten significantly the dialytic treatment session. H-HDF used a high surface area filter (1.4-1.9 m2) with high hydraulic permeability (polyacrylonitrile and polysulfone), at high blood flow (450 ml/min) and high rates of reinfusion of substitution fluid (22 l/session). In this way the dialytic session was shortened to 140 +/- 19 min, maintaining a good cardiovascular stability and high dialytic efficiency (Kt/V > 1.1). Human recombinant erythropoietin rHuEpo introduced in the therapy of this group in 1987 has resulted in an improvement of renal anaemia, but also a prolongation of the time of dialytic treatment due to a decrease in the efficiency of filters. During the period of the study, the treatment time increased from 140 +/- 19 min to 168 +/- 25 min with a concomitant increase of haematocrit and haemoglobin (from 24% to 36% and from 7.9 to 10.5 g/dl, respectively). H-HDF maintains a noticeable increase in dialytic efficacy with good cardiovascular stability, but the goal of a significant reduction in the time of treatment can no longer be obtained.
Division of Nephrology C. Monasterio Gentili, S. Chiara Hospital, Pisa, Italy.
A
A
Lippi
P
P
Rindi
R
R
Baronti
R
R
Caprioli
G
G
Favilla
D
D
Palmarini
L
L
Cioni
D000328:Adult; D000368:Aged; D000740:Anemia / Q000097:blood / Q000188:drug therapy / Q000209:etiology; D004921:Erythropoietin / Q000009:adverse effects* / Q000627:therapeutic use; D005260:Female; D006400:Hematocrit; D017583:Hemodiafiltration; D006801:Humans; D008297:Male; D008875:Middle Aged; D011994:Recombinant Proteins / Q000009:adverse effects / Q000627:therapeutic use; D013997:Time Factors; D014511:Uremia / Q000150:complications / Q000188:drug therapy / Q000628:therapy
D011994:Recombinant Proteins; D004921:Erythropoietin