[Long-term clinical experience in post-dilution HFR].
OBJECTIVE
Hemodiafiltration reinfusion (HFR) is characterized by the use of regenerated ultrafiltrate as replacement fluid. We devised a new technique, post-dilution HFR, aimed at increasing the purification efficiency, treatment tolerability and at reducing inflammatory state.


METHODS
We performed post-dilution HFR in six uremic patients during 18 months. Dialytic efficacy, filter blood rest and cytokine behavior were evaluated.


RESULTS
Neither pyrogenic reactions nor other adverse phenomena were recorded. The tolerance to the treatment was excellent. We observed a high rate of urea extraction and optimal Kt/V values, a high extraction of beta2 microglobulin (beta2-m) and a reduction in blood rest; in addition, interleukin-6 (IL-6) and tumor necrosis factor-alpha (TNF-alpha) significantly decreased. CONCLUSIONS. The inversion of the standard HFR configuration allowed us to improve the removal of both urea and beta2-m, and the blood rest, with an optimal tolerability. Moreover, the reduction in cytokine levels could attenuate the uremic microinflammatory state.
Meloni
C
C
U.O.C. di Nefrologia e Dialisi, Ospedale S. Eugenio, Rome. jumel@tin.it
Ghezzi
P M
PM
Cipriani
S
S
Rossi
V
V
Tozzo
C
C
Rossini
B
B
Dominijanni
S
S
Di Franco
D
D
Cecilia
A
A
Straccialano
E
E
Casciani
C U
CU
D000328:Adult; D000368:Aged; D005260:Female; D017583:Hemodiafiltration / Q000379:methods*; D015312:Hemodialysis Solutions / Q000008:administration & dosage*; D006801:Humans; D008297:Male; D008875:Middle Aged; D013997:Time Factors
D015312:Hemodialysis Solutions