title: Online hemodiafiltration: 4 years of clinical experience.
abstract: Online hemodiafiltration (online HDF) is a new hemodialysis technique combining convection and diffusion and thus also enabling the purification of large molecules. As yet, only a small number of clinical experiences have been published about the effectiveness and safety of online HDF. We present a prospective and observational study conducted on 31 patients treated with online HDF in our center in the last 4 years. The purpose of the study is to compare the evolution of the following aspects before and after starting online HDF: dose of dialysis, purification of medium-sized/large molecules, inflammation, nutrition, Ca-P metabolism, anemia, and intradialytic complications. Online HDF increased Kt/V to 31.0% (p > 0.001) and reduced postdialysis beta(2)-M to 66.4% (p > 0.001). The rest of the parameters analyzed did not vary significantly. During online HDF, episodes of symptomatic hypotension fell by 45% in relation to conventional hemodialysis, and no relevant complication occurred. Online HDF is very useful in patients in whom we need to increase replacement therapy, such as patients with a large body surface, those in whom we suspect a residual syndrome or those who have been receiving dialysis for a long time and for whom we wish to prevent amyloidosis. Online HDF is safe and better tolerated than conventional hemodialysis.
authors.affiliation: Nephrology Department, Hospital de Galdakao, Galdakao-Vizcaya, Spain. rmunoz@hgda.osakidetza.net
authors.forename: Rosa
authors.initials: R
authors.lastname: Muñoz
authors.forename: Isabel
authors.initials: I
authors.lastname: Gallardo
authors.forename: Evandro
authors.initials: E
authors.lastname: Valladares
authors.forename: Ramón
authors.initials: R
authors.lastname: Saracho
authors.forename: Isabel
authors.initials: I
authors.lastname: Martínez
authors.forename: Julen
authors.initials: J
authors.lastname: Ocharan
authors.forename: Jesús
authors.initials: J
authors.lastname: Montenegro
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000740:Anemia / Q000209:etiology; D002130:Calcium Phosphates / Q000378:metabolism; D005260:Female; D017583:Hemodiafiltration / Q000009:adverse effects / Q000295:instrumentation* / Q000379:methods; D006801:Humans; D007022:Hypotension / Q000209:etiology; D007249:Inflammation / Q000209:etiology; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D009747:Nutritional Physiological Phenomena; D009862:Online Systems; D016896:Treatment Outcome
chemical_list: D002130:Calcium Phosphates; C020243:calcium phosphate