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Systematic Comparison of Uremic Toxin Removal Using Different Hemodialysis Modes: A Single-Center Crossover Prospective Observational Study

Many hypotheses could explain the mortality decrease observed using hemodiafiltration, such as reduction of intradialytic hypotension and more efficient toxin removal. We led a systematic analysis of representative uremic toxin removal with hemodialysis (HD), online postdilution hemodiafiltration (p...

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Autores principales: Duval-Sabatier, Ariane, Burtey, Stephane, Pelletier, Marion, Laforet, Manon, Dou, Laetitia, Sallee, Marion, Lorec, Anne-Marie, Knidiri, Hafssa, Darbon, Floriane, Berland, Yvon, Brunet, Philippe
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9952943/
https://www.ncbi.nlm.nih.gov/pubmed/36830910
http://dx.doi.org/10.3390/biomedicines11020373
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author Duval-Sabatier, Ariane
Burtey, Stephane
Pelletier, Marion
Laforet, Manon
Dou, Laetitia
Sallee, Marion
Lorec, Anne-Marie
Knidiri, Hafssa
Darbon, Floriane
Berland, Yvon
Brunet, Philippe
author_facet Duval-Sabatier, Ariane
Burtey, Stephane
Pelletier, Marion
Laforet, Manon
Dou, Laetitia
Sallee, Marion
Lorec, Anne-Marie
Knidiri, Hafssa
Darbon, Floriane
Berland, Yvon
Brunet, Philippe
author_sort Duval-Sabatier, Ariane
collection PubMed
description Many hypotheses could explain the mortality decrease observed using hemodiafiltration, such as reduction of intradialytic hypotension and more efficient toxin removal. We led a systematic analysis of representative uremic toxin removal with hemodialysis (HD), online postdilution hemodiafiltration (postHDF) and online predilution hemodiafiltration (preHDF), in a single-center crossover and prospective observational study. The primary outcome was the reduction ratio of uremic toxins of the three categories defined by the Eutox group. Twenty-six patients were treated by those three techniques of extra renal epuration. Mean Kt/Vurea was not different between the treatment methods. Mean reduction ratio of beta2microglobulin was significantly higher for both HDF treatments than for HD (p < 0.001). Myoglobin, kappa, and lambda free light chain reduction ratio was significantly different between the modes: 37.75 ± 11.95%, 45.31 ± 11% and 61.22 ± 10.56%/57.21 ± 12.5%, 63.53 ± 7.93%, and 68.40 ± 11.79%/29.12 ± 8.44%, 34.73 ± 9.01%, and 45.55 ± 12.31% HD, preHDF, and postHDF, respectively (p < 0.001). Mean protein-bound solutes reduction ratio was not different between the different treatments except for PCS with a higher reduction ratio during HDF treatments. Mean albumin loss was always less than 2 g. HDF improved removal of middle molecules but had no effect on indoles concentration without any difference between synthetic dialysis membranes.
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spelling pubmed-99529432023-02-25 Systematic Comparison of Uremic Toxin Removal Using Different Hemodialysis Modes: A Single-Center Crossover Prospective Observational Study Duval-Sabatier, Ariane Burtey, Stephane Pelletier, Marion Laforet, Manon Dou, Laetitia Sallee, Marion Lorec, Anne-Marie Knidiri, Hafssa Darbon, Floriane Berland, Yvon Brunet, Philippe Biomedicines Communication Many hypotheses could explain the mortality decrease observed using hemodiafiltration, such as reduction of intradialytic hypotension and more efficient toxin removal. We led a systematic analysis of representative uremic toxin removal with hemodialysis (HD), online postdilution hemodiafiltration (postHDF) and online predilution hemodiafiltration (preHDF), in a single-center crossover and prospective observational study. The primary outcome was the reduction ratio of uremic toxins of the three categories defined by the Eutox group. Twenty-six patients were treated by those three techniques of extra renal epuration. Mean Kt/Vurea was not different between the treatment methods. Mean reduction ratio of beta2microglobulin was significantly higher for both HDF treatments than for HD (p < 0.001). Myoglobin, kappa, and lambda free light chain reduction ratio was significantly different between the modes: 37.75 ± 11.95%, 45.31 ± 11% and 61.22 ± 10.56%/57.21 ± 12.5%, 63.53 ± 7.93%, and 68.40 ± 11.79%/29.12 ± 8.44%, 34.73 ± 9.01%, and 45.55 ± 12.31% HD, preHDF, and postHDF, respectively (p < 0.001). Mean protein-bound solutes reduction ratio was not different between the different treatments except for PCS with a higher reduction ratio during HDF treatments. Mean albumin loss was always less than 2 g. HDF improved removal of middle molecules but had no effect on indoles concentration without any difference between synthetic dialysis membranes. MDPI 2023-01-27 /pmc/articles/PMC9952943/ /pubmed/36830910 http://dx.doi.org/10.3390/biomedicines11020373 Text en © 2023 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Communication
Duval-Sabatier, Ariane
Burtey, Stephane
Pelletier, Marion
Laforet, Manon
Dou, Laetitia
Sallee, Marion
Lorec, Anne-Marie
Knidiri, Hafssa
Darbon, Floriane
Berland, Yvon
Brunet, Philippe
Systematic Comparison of Uremic Toxin Removal Using Different Hemodialysis Modes: A Single-Center Crossover Prospective Observational Study
title Systematic Comparison of Uremic Toxin Removal Using Different Hemodialysis Modes: A Single-Center Crossover Prospective Observational Study
title_full Systematic Comparison of Uremic Toxin Removal Using Different Hemodialysis Modes: A Single-Center Crossover Prospective Observational Study
title_fullStr Systematic Comparison of Uremic Toxin Removal Using Different Hemodialysis Modes: A Single-Center Crossover Prospective Observational Study
title_full_unstemmed Systematic Comparison of Uremic Toxin Removal Using Different Hemodialysis Modes: A Single-Center Crossover Prospective Observational Study
title_short Systematic Comparison of Uremic Toxin Removal Using Different Hemodialysis Modes: A Single-Center Crossover Prospective Observational Study
title_sort systematic comparison of uremic toxin removal using different hemodialysis modes: a single-center crossover prospective observational study
topic Communication
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9952943/
https://www.ncbi.nlm.nih.gov/pubmed/36830910
http://dx.doi.org/10.3390/biomedicines11020373
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