| The Changes of Clinical Markers, beta2-microglobulin and Oxidized LDL, after Converting to On-line Hemodiafiltration from High-flux Hemodialysis |
| Jun Am Shin, M.D.1, Eun-Hee Jang, M.D.2, Hyunjeong Baek, M.D.3, So-Yeon Choi, M.D.4 Min-Ok Kim, M.D.4, Jung Eun Lee, M.D.1, Wooseong Huh, M.D.1, Dae Joong Kim, M.D.1 Ha-Young Oh, M.D.1 and Yoon-Goo Kim, M.D.1 |
Department of Internal Medicinel, Samsung Medical Center College of Medicine, Sungkyunkwan University, Seoul, Koera Department of Interna Medicine2
College of Medicine, Cheju National University, Cheju, Korea Department of Internal Medicine3
College of Medicine, Kangwon National University, Chuncheon, Korea Department of Internal Medicine4
College of Medicine, Eulji University, Daejeon, Korea |
| 원저 : 고유량 혈액투석에서 온라인 혈액여과투석법으로 전환 후 임상 소견과 beta 2-microglobulin 및 oxidized LDL의 변화 |
| 신준암1•장은희2•백현정3•최소연4•김민옥4•이정은1•허우성1•김대중1•오하영1•김윤구1 |
| 성균관대학교 의과대학 삼성서울병원 내과학교실1, 제주대학교 의과대학 내과학교실2 강원대학교 의과대학 내과학교실3, 을지대학교 의과대학 내과학교실4 |
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| Abstract |
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Purpose : Hemodiafiltration with the on-line regeneration of ultrafiltrate (on-line hemodiafiltration, OLHDF) provides better clearance of both small and large solutes than high-flux hemodialysis (HFHD) and may reduce inflammation and oxidative stress. The purpose of this observational study was to ascertain whether OL-HDF improves clinical markers after switching from HFHD to OL-HDF in patients with end-stage renal disease.
Methods : Fourteen stable patients on HFHD for at least 6 months were switched to OL-HDF. We observed changes in subjective symptoms, the levels of hemoglobin, erythropoietin dose, Kt/V, URR, beta 2-microglobulin, plasma oxidized LDL (OxLDL) and CRP for twelve-months period.
Results : There were improvements in subjective symptoms including fatigue, anorexia, insomnia and itching sensation (p<0.05). There were significant increases in Kt/V (1.63±0.17 vs. 1.77±0.24, p< 0.05) and URR (75.1±3.2 vs. 77.2±3.9%, p<0.05). Even though erythropoietin dose was not changed, hemoglobin level was increased (10.6±1.3 vs. 11.4±1.0, p<0.05). Beta 2-microglobulin clearance was significantly increased (17.7±4.4 vs. 21.9±6.1 mL/min, p<0.05). However, the pre-dialysis level of beta 2-microglobulin was not significantly reduced. The pre-dialysis level of CRP was not changed. OxLDL reduction ratio was not changed. On the other hand, the pre-dialysis plasma level of OxLDL was
significantly reduced (32.36±6.03 vs. 26.05±6.00 U/L, p<0.05).
Conclusion : OL-HDF improved several subjective symptoms, anemia, the clearance of small solute, beta 2-microglobulin level and reduced plasma OxLDL after switching from HFHD. Less OxLDL may be generated in OL-HDF compared with HFHD.
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| Key Words:
Hemodiafiltration, Beta 2-microglobulin, Oxidized LDL |
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