Intradialytic glucose infusion increases polysulphone membrane permeability and post-dilutional haemodiafiltration performances.
BACKGROUND
During real-time monitoring of the ultrafiltration coefficient (Kuf) in haemodiafiltration (HDF), it was noticed that the ultrafiltration performance of polysulphone membrane dialysers increased when hypertonic glucose (D50%) was administered through the venous blood return.


METHODS
This observation was explored in six non-diabetic chronic dialysis patients during 48 HDF sessions using 1.8 m(2) polysulphone membrane dialysers. In all six patients, 24 sessions were performed with glucose supplementation (as a continuous D50% (500 g/l) infusion at 40 ml/h) and 24 sessions without supplementation.


RESULTS
Glucose supplementation led to a marked increase in Kuf from 22.8+/-2.2 (without D50%, n=24) to 32. 1+/-3.9 ml/h/mmHg (with D50%, n=24) (P<0.0001). An increase in percentage reduction ratios for urea and creatinine were also consistently observed during the sessions with glucose administration (from respective mean values of 75+/-5 and 68+/-4% to 79+/-4 and 74+/-10%). Mean double-pool Kt/V, calculated from serum urea concentrations, rose from 1.65+/-0.24 (n=24) to 1.86+/-0.24 (n=24) (P<0.005). Similar results were observed in a subgroup of 18 HDF sessions (nine with glucose and nine without) monitored with an on-line urea sensor of spent dialysate. No detrimental effects were induced at any time.


CONCLUSIONS
We conclude that intravenous glucose administration during high-flux HDF using polysulphone membranes increases significantly both ultrafiltration capacity and dialysis dose delivery.
Vaussenat
F
F
Department of Nephrology, Lapeyronie University Hospital, Montpellier, France.
Canaud
B
B
Bosc
J Y
JY
Leblanc
M
M
Leray-Moragues
H
H
Garred
L J
LJ
D000328:Adult; D001672:Biocompatible Materials / Q000378:metabolism*; D003404:Creatinine / Q000097:blood; D015314:Dialysis Solutions / Q000493:pharmacokinetics; D005260:Female; D005947:Glucose / Q000008:administration & dosage* / Q000493:pharmacokinetics; D017583:Hemodiafiltration / Q000295:instrumentation / Q000592:standards*; D006801:Humans; D007262:Infusions, Intravenous; D008297:Male; D008567:Membranes, Artificial; D010539:Permeability; D011108:Polymers / Q000378:metabolism*; D051437:Renal Insufficiency / Q000097:blood / Q000628:therapy; D013450:Sulfones / Q000378:metabolism*; D014462:Ultrafiltration / Q000295:instrumentation; D014508:Urea / Q000097:blood
D001672:Biocompatible Materials; D015314:Dialysis Solutions; D008567:Membranes, Artificial; D011108:Polymers; D013450:Sulfones; C017662:polysulfone P 1700; D014508:Urea; D003404:Creatinine; D005947:Glucose