Korean Journal of Nephrology 1998;17(2):250-257.

On - Line Henodiafiltration의 치험

김현철

Abstract

A prospective study was done to evaluate the on- line hemodiafiltration(HDF) as a safe and efficient way to increase B-microglobulin(B-M) removal. We have compared treatrnent with hemodialysis(HD) and HDF in 10 stable patients over a period of three months. All HDF sessions were well tolerated. No pyrogenic reactions were observed during the study. Cardiovascular parameters were remarkably similar in both of treatment periods. However, the incidence of hypotension was significantly less frequent during HDF peroid(9.43% vs. 2.41%, P=0.04). The reduction rates of urea and creatinine were similar in both of treatment periods, ranging 60-70%, The B-M reduction rate was significantly improved by HDF compared to HD(43.2% vs. 6.8%, P=0.006), The serum B-M levels fell progressively from the HD value of 32.2mg/L to 21.0mg/L at the end of 3 months HDF. In conclusion, HDF with on-line production of substitution fluid in has been confirmed by us to be a safe and more efficient way to increase Bz-M removal. Long-term clinical studies are necessary to determine whether improved removal of B -M will reduce or prevent the dialysis amyloidosis.