title: [Predilution online hemodiafiltration: which dose of anticoagulation?].
abstract: BACKGROUND
  Patients in end stage renal disease on hemodialysis are in higher risk of bleeding related to the anticoagulation used during a session, so only the lowest effective dose of anticoagulation must be used. The aim of this study was to evaluate the efficacy of predilution in hemodiafiltration with reduced dose of anticoagulation compared to hemodialysis in preventing coagulation of circuits.
  
  
  METHODS
  This study was conducted in stable hemodialysis patients without high bleeding risk. All patients were treated by two different treatments: (A) conventional hemodialysis, (B) predilution hemodiafiltration with the half dose of anticoagulation used during treatment (A). Other confounding parameters were kept constant during the study. The primary endpoint was the incidence of major thrombotic events judged on a subjective visual score.
  
  
  RESULTS
  Twenty-one patients were included (105 sessions for each treatment). Major incidents are occurring more frequently in predilution hemodiafiltration with reduced dose of anticoagulation (P=0.03). The premature discontinuation of sessions was more frequent in predilution hemodiafiltration, this difference was not significant (P=0.07). Duration of sessions was significantly shorter in predilution hemodiafiltration (P=0.03). The higher frequency of thrombotic events in predilution hemodiafiltration has no effect on net ultrafiltration volume achieved in both treatments.
  
  
  CONCLUSIONS
  Predilution hemodiafiltration with a lower dose of anticoagulation did not prevent major clotting of extracorporeal circuit manner at least equivalent to a reference method.
authors.affiliation: Service de néphrologie, dialyse et transplantation rénale, hôpital militaire d'instruction Mohammed V, Hay Riad, BP 10100, Rabat, Maroc. Electronic address: acideamine83@yahoo.fr.
authors.forename: Mohamed Amine
authors.initials: MA
authors.lastname: Hamzi
authors.affiliation: Service de néphrologie, dialyse et transplantation rénale, hôpital militaire d'instruction Mohammed V, Hay Riad, BP 10100, Rabat, Maroc.
authors.forename: Kawtar
authors.initials: K
authors.lastname: Hassani
authors.affiliation: Service de néphrologie, dialyse et transplantation rénale, hôpital militaire d'instruction Mohammed V, Hay Riad, BP 10100, Rabat, Maroc.
authors.forename: Ahmed
authors.initials: A
authors.lastname: Alayoud
authors.affiliation: Service de néphrologie, dialyse et transplantation rénale, hôpital militaire d'instruction Mohammed V, Hay Riad, BP 10100, Rabat, Maroc.
authors.forename: Wafaa
authors.initials: W
authors.lastname: Arache
authors.affiliation: Service de néphrologie, dialyse et transplantation rénale, hôpital militaire d'instruction Mohammed V, Hay Riad, BP 10100, Rabat, Maroc.
authors.forename: Abdelali
authors.initials: A
authors.lastname: Bahadi
authors.affiliation: Laboratoire de biostatistique et de recherche clinique et épidémiologique, faculté de médecine et de pharmacie de Rabat, Rabat, Maroc.
authors.forename: Jalal
authors.initials: J
authors.lastname: Kasouati
authors.affiliation: Service de néphrologie, dialyse et transplantation rénale, hôpital militaire d'instruction Mohammed V, Hay Riad, BP 10100, Rabat, Maroc.
authors.forename: Mohamed
authors.initials: M
authors.lastname: Benyahia
mesh_terms: D000925:Anticoagulants / Q000008:administration & dosage*; D005260:Female; D017583:Hemodiafiltration / Q000379:methods; D006801:Humans; D007676:Kidney Failure, Chronic / Q000097:blood / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D006435:Renal Dialysis / Q000379:methods*
chemical_list: D000925:Anticoagulants