What infusion flow should be used for mid-dilution hemodiafiltration?
BACKGROUND
There is still no consensus on the optimal infusion flow (Qi) in mid-dilution hemodiafiltration. The aim of this study was to compare mid-dilution with varying Qi.


METHODS
Prospective study in 25 patients who underwent seven hemodialysis sessions with a Qi of 0, 50, 100, 150, 200, 250 and 300 ml/min.


RESULTS
All sessions were well tolerated except Qi 300 ml/min. No significant differences in urea, creatinine, alpha(1)-microglobulin or alpha(1)-acid glycoprotein reduction ratios were observed. beta(2)-Microglobulin, myoglobin and prolactin reduction ratios were higher with Qi 150, 200, 250 and 300 ml/min in comparison with Qi of 0, 50 and 100 ml/min. There were no differences in the removal of small or larger molecules when Qi was 150 ml/min or higher.


CONCLUSIONS
Optimal Qi in mid-dilution appears to be in the range of 150-250 ml/min since good clinical outcomes, similar efficiency and no technical complications up to a Qi of 250 ml/min were observed.
Maduell
Francisco
F
Department of Nephrology, Hospital Clínic Barcelona, Barcelona, Spain. fmaduell@clinic.ub.es
Arias
Marta
M
Fontseré
Néstor
N
Vera
Manel
M
Masso
Elisabeth
E
Garro
Julia
J
Barros
Xoana
X
Martina
Maria N
MN
Elena
Montserrat
M
Bergadá
Eduardo
E
Cases
Aleix
A
Bedini
Jose Luis
JL
Campistol
Josep M
JM
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D017583:Hemodiafiltration / Q000009:adverse effects / Q000379:methods*; D006438:Hemodilution / Q000009:adverse effects / Q000379:methods*; D006801:Humans; D007262:Infusions, Intravenous / Q000009:adverse effects / Q000379:methods*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D014511:Uremia / Q000097:blood / Q000628:therapy*; D055815:Young Adult