title: Randomized trial of frequent low-efficiency and short hemodialysis/hemofiltration in hemodialysis patients with acute brain injury.
abstract: OBJECTIVE
  The aim of the study was to compare effects of frequent low-efficiency and short hemodialysis (FLESHD) and frequent low-efficiency and short hemofiltration (FLESHF) in hemodialysis (HD) patients with acute brain injury (ABI).
  
  
  METHODS
  We randomly divided 13 HD patients with ABI into FLESHD (n = 6) or FLESHF (n = 7) groups. Conditions for the first to third sessions were as follows.
  intravenous administration of glycerol 400 ml/session, blood flow rate (QB) 100 ml/min, dialysate flow rate 300 ml/min, and treatment duration 2 h (HD-1).
  intravenous administration of glycerol 400 ml/session, QB 150 ml/min, substitution flow rate 10 l/session, and treatment duration 4 h (HF-1). After the fourth session, we gradually changed the conditions and stopped glycerol administration (HD-2 and HF-2).
  
  
  RESULTS
  There were no significant differences in survival rate, consciousness level, or adverse effects during hospitalization in either group. In mixed model analysis, the level of HCO3- post FLESHF was significantly (p<0.0001) increased compared with the level post FLESHD. However, no significant differences were seen in the levels of osmolality, in blood pressure before and after either dialysis method, or in the level of HCO3- pre dialysis. The variation in the relative ratio of BUN before FLESHF was significantly higher (p<0.05) than the relative ratio before FLESHD in the sixth session. In the FLESHD groups, serum sodium was higher and serum potassium was lower than in the FLESHF groups.
  
  
  CONCLUSIONS
  FLESHD with glycerol under these conditions may be a better therapeutic option for managing patients with ABI, although the short-term survival rate is similar.
authors: Division of Nephrology, Hypertension and Endocrinology, Department of Internal Medicine, Nihon University School of Medicine, Tokyo - Japan.
authors: Kazuyoshi
authors: K
authors: Okada
authors: Masanori
authors: M
authors: Abe
authors: Hiroyuki
authors: H
authors: Takashima
authors: Seishiro
authors: S
authors: Baba
authors: Machiko
authors: M
authors: Taniguchi
authors: Hiroko
authors: H
authors: Suzuki
authors: Yoshinori
authors: Y
authors: Yoshida
authors: Osamu
authors: O
authors: Oikawa
authors: Noriaki
authors: N
authors: Maruyama
authors: Masayoshi
authors: M
authors: Soma
mesh_terms: D001930:Brain Injuries; D015314:Dialysis Solutions; D006440:Hemofiltration; D006801:Humans; D007676:Kidney Failure, Chronic / Q000628:therapy; D006435:Renal Dialysis
chemical_list: D015314:Dialysis Solutions