One year of clinical experience in postdilution hemofiltration with online reinfusion of regenerated ultrafiltrate.
OBJECTIVE
Hemofiltrate reinfusion (HFR) is characterized by the use of regenerated ultrafiltrate as replacement fluid. We set up a new technique, postdilution HFR (PD-HFR), aiming at increasing purification efficiency, treatment tolerance and at reducing inflammatory states.


METHODS
We performed PD-HFR in 6 uremic patients during 1 year. Dialysis efficacy, dialyzer blood loss and the behavior of cytokines were evaluated.


RESULTS
No pyrogenic reactions or other adverse events were recorded. Treatment tolerance was excellent. We observed high urea extraction rates and optimal Kt/V values, high beta2-microglobulin (beta2m) extraction rates and a decrease in dialyzer blood loss; also IL-6 and TNF-alpha decreased significantly.


CONCLUSIONS
Inversion of the standard HFR configuration has allowed us to improve the removal of both urea and beta2m, and to decrease dialyzer blood loss, with an optimal tolerance. Moreover, the decrease in cytokine levels might attenuate the uremic microinflammatory state.
Meloni
Carlo
C
Nephrology and Dialysis Department, S. Eugenio Hospital, Rome, Italy.
Ghezzi
Paolo M
PM
Cipriani
Silvia
S
Petroni
Sandro
S
Del Poeta
Giovanni
G
Rossini
Bernardo
B
Rossi
Valeria
V
Recino
Gabriele
G
Suppo
Giovanna
G
Cecilia
Annalisa
A
Casciani
Carlo U
CU
D000328:Adult; D000368:Aged; D005260:Female; D005500:Follow-Up Studies; D017583:Hemodiafiltration / Q000379:methods*; D015312:Hemodialysis Solutions / Q000008:administration & dosage*; D006801:Humans; D008297:Male; D008875:Middle Aged
D015312:Hemodialysis Solutions