Kidney Week

Abstract: SA-PO420

The Effect of Hemodiafiltration vs. High-Flux Dialysis on Middle- and Large-Sized Molecules' Reduction and Its Relation to Albumin Loss Using Big Surface-Area Dialyzer 2.6 m2

Session Information

• Hemodialysis and Frequent Dialysis: Clearance, Technology, Infection
  November 05, 2022 | Location: Exhibit Hall, Orange County Convention Center‚ West Building
  Abstract Time: 10:00 AM - 12:00 PM

Category: Dialysis

• 701 Dialysis: Hemodialysis and Frequent Dialysis

Authors

• Elsayed, Hesham Mohamed, Ain Shams University Faculty of Medicine, Cairo, Egypt

Hesham Mohamed Elsayed,

• ElSharkawy, Magdy, Ain Shams University Faculty of Medicine, Cairo, Egypt

Magdy ElSharkawy,

• Aref, Hayam M., Ain Shams University Faculty of Medicine, Cairo, Egypt

Hayam M. Aref,

• Abdelmohsen, Waleed Anwar, Ain Shams University Faculty of Medicine, Cairo, Egypt

Waleed Anwar Abdelmohsen,

• Khedr, Abdelrahman Nabil, Ain Shams University Faculty of Medicine, Cairo, Egypt

Abdelrahman Nabil Khedr,

• Abdallah, Hussein Sayed Hussein, Ain Shams University Faculty of Medicine, Cairo, Egypt

Hussein Sayed Hussein Abdallah,

• Abdallah, Shaimaa Zaki abdelmegied, Ain Shams University Faculty of Medicine, Cairo, Egypt

Shaimaa Zaki abdelmegied Abdallah,

• Sultan, Reem Ahmed, Ain Shams University Faculty of Medicine, Cairo, Egypt

Reem Ahmed Sultan,

• Radwan, Mohamed Fathy, Ain Shams University Faculty of Medicine, Cairo, Egypt

Mohamed Fathy Radwan,

• Magdi, Aya Mohamed, Ain Shams University Faculty of Medicine, Cairo, Egypt

Aya Mohamed Magdi,

• Abdelwahab, Khaled Gouda, Ain Shams University Faculty of Medicine, Cairo, Egypt

Khaled Gouda Abdelwahab,

• Elbraky, Abdelrahman Ali, Ain Shams University Faculty of Medicine, Cairo, Egypt

Abdelrahman Ali Elbraky,

• Emara, Ahmed, Ain Shams University Faculty of Medicine, Cairo, Egypt

Ahmed Emara,

Background

Uremic toxins are classified into small, middle-sized, and protein-bound solutes. Removal of middle-sized molecules with minimal albumin loss is needed. This study assessed different molecules’ removal using 2.6m² surface area (SA) dialyzer on high-flux haemodialysis (HF-HD) vs. hemodiafiltration (HDF) and its relation to albumin loss

Methods

A crossover study included 25 patients, underwent HF-HD followed by online post-dilution HDF using dialyzer; BIOPURE (Biorema) 260 HF (with a SA 2.6 m², High-flux hollow Fiber Hemodialysis membrane with steam sterilization, myoglobin SC 0.7, membrane cutoff value 40 KDa.), with 2-weeks washout period. All patients were subjected to single session assessment of cumulative dialysate albumin loss, and to measurement of pre-post dialysis Reduction values of Kappa and Lambda free light chains (FLC), α-1-microglobulin (MG), IL-6 and procalcitonin by ELISA.

Results

There was significant reduction in post-dialysis levels of all molecules in HF-HD and HDF compared to pre-dialysis levels (P<0.001). HDF showed higher post dialysis reduction ratio of kappa and lambda FLC, α 1-MG, IL-6 and procalcitonin (P<0.001). Total dialysate albumin loss on HDF was higher compared to HF-HD with median of 2.46 (1.7 – 2.8 IQR), 0.65 (0.48 – 1.1 IQR) respectively. Maximum albumin loss on HDF was in the first hour with a median of 1.20 (0.77 – 1.3 IQR). Transmembrane pressure was positively correlated with total albumin loss in both modalities.

Conclusion

BIOPURE (Biorema) 260 HF, 2.6 m² SA, may be effective in medium-sized molecules’ removal especially with online post-dilution HDF with acceptable albumin loss

RR% of different molecules in HD vs HDF

Funding

• Private Foundation Support