Treatment frequency and efficiency in hemodiafiltration.

Background: One of the main objectives of dialysis is uremic retention product elimination. Efficiency of dialysis modalities varies both regarding the range of solutes removed and the extent of such removal. We analyzed plasma (or blood) concentrations of marker solutes in intermittent treatment schedules using hemodiafiltration (HDF). Methods: Elimination and rebound of uremic solutes were measured in 10 patients (77 +/- 12 kg, 66.5 +/- 9.2 years) treated with postdilution HDF in one 4-hour treatment and in two 2-hour treatments on consecutive days (Polyflux 2.1 m(2), QB 451 +/- 53 ml/min, QD 598 +/- 13 ml/min). Blood urea, creatinine, phosphate, beta(2)-microglobulin, complement factor D and advanced glycation end products were analyzed before, during and after HDF for 24-48 h. Results: Applying two 2-hour HDF treatments on consecutive days resulted in significantly lower plasma (or blood) levels of urea, creatinine, phosphate, beta(2)-microglobulin, and advanced glycation end products after 48 h than using one 4-hour session. Conclusions: Increased treatment frequency could further optimize blood purification in HDF therapy. Copyright (C) 2013 S. Karger AG, Basel