[Hemodiafiltration with endogenous reinfusion (HFR): biochemical and gas-analytical analysis of the "regenerated" ultrafiltrate].
OBJECTIVE
During convective techniques, a replacement fluid (R) is necessary that is sterile and pyrogen-free. Using an integrated absorption cartridge, the ultrafiltrate (UF) can be "regenerated"; and used as R. This method is hemodiafiltration with reinfusion (HFR). This study aimed to evaluate the real UF composition after "regeneration" by the resin-charcoal integrated absorption cartridge.


METHODS
In eight uremic patients treated with HFR the UF was evaluated at 5, 15, 30, 60, 120, 180 and 240 min after HFR start at the inlet and the outlet resin-charcoal cartridge using the following parameters: urea, creatinine (Cr), uric acid, phosphates, glucose, Beta 2-microglobulin (beta2-m), Na+, K+, Ca++, pH, pCO2, and HCO3-.


RESULTS
Blood (%): urea -61.2 +/- 9.7; Cr -55.4 +/- 8.1; uric acid -69.8 +/- 9.3; phosphates -31.8 +/- 15.7; glucose -8.4 +/- 20.5; Beta2-m -60.3 +/- 11.1; pH +0.76 +/- 0.58; pCO2+ 3.3 +/- 8.5; HCO3- +18.1 +/- 13.5. In UF (outlet vs inlet): urea was not adsorbed; Cr and uric acid were adsorbed; phosphates were not adsorbed; glucose was partially adsorbed (only in the 1st 90 min); Beta2-m was almost totally adsorbed; Na+ and K+ were not adsorbed; for pH, pCO2, and HCO3- there were no significant variations between the inlet and the outlet.


CONCLUSIONS
HFR seems to be an easy-to-perform hemodiafiltration (HDF) technique, capable of resolving the typical problems of availability and the production of sterile and ultrapure reinfusion solution.
Costantini
S
S
U.O. di Nefrologia e Dialisi, Ospedale Belcolle, Viterbo. nefrvit2@asl.vt.it
Meschini
R
R
Meschini
L
L
Massimetti
C
C
Feriozzi
S
S
Ancarani
E
E
D001784:Blood Gas Analysis; D005260:Female; D017583:Hemodiafiltration / Q000379:methods*; D015312:Hemodialysis Solutions / Q000008:administration & dosage* / Q000032:analysis; D006801:Humans; D008297:Male; D008875:Middle Aged; D014511:Uremia / Q000097:blood / Q000628:therapy*
D015312:Hemodialysis Solutions