Effect of high haematocrit on the efficiency of high-flux dialysis therapies.
BACKGROUND
There is a concern that high haematocrit (Hct) levels will reduce the efficiency of dialysis treatments, particularly in post-dilution haemodiafiltration (HDF) where there is the potential for intense haemoconcentration within the dialyser.


METHODS
We measured serial Hct and performed serial clearance measurements for urea, phosphate, beta(2)-microglobulin and myoglobin in 12 patients with Hct >35% on high-flux haemodialysis (HFHD) or HDF. We assessed whether changes in the intra-dialyser Hct influenced solute clearance and whether there were differences between the two modalities.


RESULTS
Hct rose significantly in all treatments studied. Convective and total solute clearances were higher in the HDF group when compared to the HFHD group. Phosphate clearance in HFHD fell towards the end of dialysis when the Hct was highest but no differences were detected for the other solutes.


CONCLUSIONS
Despite marked haemoconcentration, the impact on solute clearance across the range of molecular size studied is small. These findings are reassuring in the current era of widespread erythropoietin use.
Spalding
Elaine M
EM
Renal Unit, Lister Hospital, Stevenage, UK. elaine.spalding@nhs.net
Pandya
Priya
P
Farrington
Ken
K
D000368:Aged; D005260:Female; D006400:Hematocrit; D006801:Humans; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care / Q000379:methods*; D006435:Renal Dialysis / Q000379:methods*; D051437:Renal Insufficiency / Q000097:blood / Q000175:diagnosis* / Q000517:prevention & control*; D016896:Treatment Outcome