The removal capacity of asymmetric cellulose triacetate during post-dilution online hemodiafiltration

Santos, Alba; Macías, Nicolás; Vega, Leónidas Cruzado; Vega, Almudena

doi:10.23876/j.krcp.20.243

Cited by 2 publications

(2 citation statements)

References 9 publications

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“…During a single session of post-dilution OL-HDF, the mean decrease in serum IL-6 concentration was 2.90 ± 2.83 pg/mL, while the mean IL-6 reduction index was 43.75 ± 15.60%. These results are consistent with the results of other authors, who also showed that post-dilution OL-HDF with an asymmetric triacetate cellulose membrane reduces the concentration of pro-inflammatory mediators in serum [39], [40], [41].…”

Section: Microinflammationsupporting

confidence: 93%

“…The results of the research done so far have shown that during a single session of high-flux "high-flux" hemodialysis RR-β2M is 50-60%, in extended hemodialysis ("medium cut-off" dialysis membrane) 70%, and in high-volume Vconv ≥ 22 liters/session) post-dilution OL-HDF 80-85% (RR-β2M ≥ 80%) [36], [37], [38]. In patients treated with postdilution OL-HDF with asymmetric triacetate cellulose dialysis membrane, at a blood flow rate of Qb = 400 mL/min, volume substitution -Vsubs = 24 liters/session and total convective volume -Vconv = 27.4 ± 3.4, RR-β2M was 79.3 ± 4.7%, and albumin loss during a single postdilution OL-HDF session about 500 mg (384.8-596.7 mg/4 h) [39]. The reduction index β2-M (RR-β2M) during a single session of OL-HDF with asymmetric triacetate cellulose dialysis membrane of 2.1 m 2 was 80.40%, for α1-microglobulin (RR-α1M) 23.50%, and albumin loss was <2.0 g/4 h (1.708 g/4 h) [40].…”

Section: Discussionmentioning

confidence: 99%

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Assessment of the Influence of Asymmetric Triacetate Cellulose Membrane on the Rate of Removal of Middle Molecular Weight Uremic Toxins in Patients Treated with Postdilution Online Hemodiafiltration

Nenadović

Nikolić²,

Stanojević-Pirković³

et al. 2022

Open Access Maced J Med Sci

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BACKGROUND: Postdilution online hemodiafiltration (OL-HDF) effectively removes uremic toxins of middle molecular weight from the blood of patients with end-stage chronic kidney disease. The rate of removal of uremic toxins depends on the type of dialysis membrane, blood flow rate (Qb), net ultrafiltration flow rate (Qnuf), and total convective volume (Vconv). AIM: The aim of this study was to examine the efficacy of asymmetric triacetate cellulose dialysis membrane in patients on post-dilution OL-HDF. METHODS: Thirty-five patients treated with post-dilution OL-HDF hemodiafiltration for at least 3 months were examined. The main parameters for assessing the efficiency of removal of uremic toxins of middle molecular weight are the concentration of β2-microglobulin (β2-M) and interleukin-6 (IL-6) in serum before and after a single session of post-dilution OL-HDF. The followings were used for statistical analysis: Kolmogorov–Smirnov test, Student’s T test for bound samples and Wilcoxon test. RESULTS: The average Vconv was 20.90 ± 3.30 liters/session. The β2-M reduction index during a single session of postdilution OL-HDF was 71.10 ± 6.39%, the IL-6 reduction index was 43.75 ± 15.60%, and the albumin reduction index was 4.55 ± 2.31%. CONCLUSION: The asymmetric triacetate cellulose dialysis membrane effectively removes β2-M and IL-6 during a single session of postdilution OL-HDF. The β2-M reduction index is ∼70%, the IL-6 reduction index is ∼40%, and albumin loss is <4.0 g/4 h. The examined dialysis membrane and dialysis modality prevent the development of amyloidosis associated with dialysis, microinflammation and reduce the risk of developing atherosclerotic cardiovascular diseases in the population of patients treated with regular hemodiafiltration.

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Section: Microinflammationsupporting

confidence: 93%

Section: Discussionmentioning

confidence: 99%

Assessment of the Influence of Asymmetric Triacetate Cellulose Membrane on the Rate of Removal of Middle Molecular Weight Uremic Toxins in Patients Treated with Postdilution Online Hemodiafiltration

Nenadović

Nikolić²,

Stanojević-Pirković³

et al. 2022

Open Access Maced J Med Sci

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Efficacy of medium molecular weight toxin clearance in manual mixed online hemodiafiltration vs. pre- and post-dilution online hemodiafiltration and conventional hemodialysis: A crossover observational study

Mavromatidis,

Kalogiannidou,

Passadakis

et al. 2024

Ukr. J. Nephrol. Dial.

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The effectiveness of various hemodiafiltration (HDF) modes in removing different toxins is not fully understood. The present study aimed to compare the efficacy of manual mixed online HDF with pre-dilution online HDF, post-dilution online HDF, and conventional hemodialysis in clearing medium molecular weight toxins. Methods. This single-center, crossover observational study included 11 patients (7 males, 4 females) aged 48-85 years (mean age 65.2±11.7) with a dialysis vintage of 24-455 months (mean duration 126±123 months), including 10-29 months (mean duration 19.5±6.4) on HDF. The study focused on the removal of two medium molecular weight molecules: beta 2-microglobulin and the larger prolactin. The effectiveness of various dialysis modes was evaluated in single sessions for each patient, including pre-dilution online HDF (Group A), post-dilution online HDF (Group B), a mixed dilution model with post-dilution during the first half of the session and pre-dilution during the second half (Group C), and conventional hemodialysis (Group D). Results. A statistically significant difference in the reduction of serum beta 2-microglobulin levels was observed in Group B compared to Group A (70.6±3.1% vs. 64.4±2.7%, p<0.0001) and Group C (70.6±3.1% vs. 65.9±4.9%, p<0.001), with no significant difference between Groups A and C (p=NS). For serum prolactin levels, the greatest reduction was noted in Group B, with significant differences compared to Group A (52.5±8.9% vs. 36.2±9.5%, p<0.001) and Group C (52.5±8.9% vs. 46.9±5.2%, p=0.03). Additionally, Group C showed a significant difference compared to Group A (46.9±5.2% vs. 36.2±9.5%, p<0.005). Conclusions. Post-dilution HDF is the most effective mode for removing beta 2-microglobulin and prolactin. Mixed dilution HDF also shows significant efficacy, surpassing pre-dilution HDF in toxin clearance. These findings highlight the advantage of post-dilution techniques in managing medium molecular weight toxins. Further research is needed to explore these results in greater detail and to confirm their clinical implications.

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The removal capacity of asymmetric cellulose triacetate during post-dilution online hemodiafiltration

Cited by 2 publications

References 9 publications

Assessment of the Influence of Asymmetric Triacetate Cellulose Membrane on the Rate of Removal of Middle Molecular Weight Uremic Toxins in Patients Treated with Postdilution Online Hemodiafiltration

Assessment of the Influence of Asymmetric Triacetate Cellulose Membrane on the Rate of Removal of Middle Molecular Weight Uremic Toxins in Patients Treated with Postdilution Online Hemodiafiltration

Efficacy of medium molecular weight toxin clearance in manual mixed online hemodiafiltration vs. pre- and post-dilution online hemodiafiltration and conventional hemodialysis: A crossover observational study

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