title: Plasma or whole blood concentrations of trace elements in patients treated by haemodiafiltration with on-line prepared substitution fluid.
abstract: Large membrane pores and large quantities of reinfusion fluids can influence the dialytic balance of trace elements in haemodiafiltration (HDF). As there are no studies in HDF with on-line produced reinfusate, we studied plasma or whole blood (*) concentrations of trace elements (Al, Cd*, Cr* and Se: microg/l; Cu, Pb* and Zn*: microg/dl) of 24 on-line HDF, 20 haemodialysis (HD) patients and 66 490 normal subjects (N). The concentrations of Al (11.7+/-9.5), Cd (0.73+/-0.59) and Cr (6.5+/-6.9) were significantly greater in on-line HDF patients than in normal subjects (6+/-0.4; 0.6+/-0.2; 0.5+/-0.02), but similar to those of HD patients. In on-line HDF patients, Cu (85.3+/-17.7), Pb (8+/-4.6), Se (68+/-27) and Zn (546+/-103) concentrations were less than in normal subjects (108+/-3.4; 11+/-0.8; 95+/-1.8; 673+/-23), and those of Cu and Zn were also less than in HD patients (99.5+/-16.8; 670+/-65). At the end of an on-line HDF treatment (42-69 studies), there was a significant increase in Al (from 12.8+/-9.1 to 15.4+/-8.3), Cr (from 7.2+/-6.4 to 9.5+/-7), Cu (from 97.3+/-21.5 to 109.4+/-27.2) and Zn (from 577+/-108 to 619+/-117). A longitudinal study (n = 16-18) for 12-30 months documented stable concentrations of Al, Cd, Cr, Se and Zn and a significant increase of Cu and Pb to normal concentrations. In conclusion, our on-line HDF patients have elevated Al, Cd, Cr and decreased Cu, Pb, Se, Zn concentrations in plasma or whole blood determinations. Cu and Pb normalize with time; the other trace elements remain stable as documented by numerous determinations. As the values for on-line HDF patients are similar to those of HD patients, the level of accumulation or depletion of trace elements in on-line HDF can be considered as safe as in HD; the increase in Al, Cd, Cu and Zn at the end of treatment may be an expression of the increase of those trace elements linked to proteins.
authors.affiliation: Servizio di Nefrologia e Dialisi, Ospedale di Desio, Milano, Italy.
authors.forename: G
authors.initials: G
authors.lastname: Bonforte
authors.forename: M
authors.initials: M
authors.lastname: Surian
authors.forename: B
authors.initials: B
authors.lastname: Dozio
authors.forename: R
authors.initials: R
authors.lastname: Scanziani
authors.forename: A
authors.initials: A
authors.lastname: Baj
authors.forename: S
authors.initials: S
authors.lastname: Colombo
authors.forename: F
authors.initials: F
authors.lastname: Toffoletto
mesh_terms: D015314:Dialysis Solutions / Q000008:administration & dosage* / Q000627:therapeutic use; D017583:Hemodiafiltration / Q000379:methods; D006801:Humans; D008137:Longitudinal Studies; D008875:Middle Aged; D009862:Online Systems / Q000295:instrumentation; D014131:Trace Elements / Q000097:blood*
chemical_list: D015314:Dialysis Solutions; D014131:Trace Elements