Comparison of two hours' biofiltration and four hours' bicarbonate hemodialysis by multiple clinical parameters

• Published in: Nihon Jinzo Gakkai shi Vol. 33; no. 6; pp. 605 - 613
• Main Authors: NAKAGAWA, SEINOSUKE, INOUE, ATSUSHI, OKUDA, KENJI, OGURA, MITSUO, KURIYAMA, RENJIRO, GOTOU, KEN, SAKURAI, SHUNICHIRO, HOSHINO, MASANOBU, MATSUI, NORIAKI
• Format: Journal Article
• Language: Japanese
• Published: Japan Japanese Society of Nephrology 1991
• Subjects: Adult; bicarbonate hemodialysis; Bicarbonates; biofiltration; Blood Urea Nitrogen; Creatinine - blood; Evaluation Studies as Topic; Female; hemodialysis; Hemodynamics; Hemofiltration - methods; Humans; Kidney Failure, Chronic - physiopathology; Kidney Failure, Chronic - therapy; Male; Middle Aged; protein catebolic rate; Renal Dialysis - methods; Sodium; Sodium Bicarbonate; Time Factors; urea index
• ISSN: 0385-2385; 1884-0728
• DOI: 10.14842/jpnjnephrol1959.33.605

Ten uremic patients maintained stable on regular dialysis treatment participated in a comparison study of 2 hours' biofiltration and 4 hours' bicarbonate hemodialysis with informed consents. In biofiltration, ultrafiltrate was replaced by a solution consisting of Na 145 mEq/l, HCO3- 100 and Cl 45 at the infusion rate 2.51/hour. Dialysate composition was Na 130-149 mEq/l, K 1.0, Cl 119, Ca 2.5, Mg 0.5, CH3COO-15 and glucose 200 mg/dl. Hemodiafilter was F80, polysulphone, 1.9 m2, manufactured by Fresenius Co. Ltd. Blood flow rate was 5 ml/min/kg·body·weight to keep urea index (Kt/V) over 1.0. B-A-B' comparison was designed in which B and B' stand for 4 hours' bicarbonate hemodialysis while A for 2 hours' biofiltration, 3 times per week for 2 months, respectively. It was intended to find out if there are aggravations of clinical parameters in A after B and/or improvements in B' after A in view of evaluation of optimum for 2 hours' biofiltration. One patient was withdrawn from biofiltration at 15th treatment in A because of frequent muscular twitchings. Others finished the whole program, thus making drop-out rate 10%. No significant differences were observed in the following parameters between B and A and between A and B': cardiothoratic ratio, pre-treatment blood pressure, human atrial natriuretic hormone, cardiovascular dynamics, total protein, BUN, serum creatinine, uric acid, β2 microglobulin, blood counts, blood gas analysis, elctrolytes, alkaline-phosphatase, PTH-C, protein catabolic rate (PCR), lipids and liver functions. Pre-treatment levels of inorganic phosphorus in the blood were significantly decreased from 6.1±0.9 mg/dl in A to 5.0±1.3 in B' (p<0.05, n=9). PCR developed an increasing tendency in A, 1.31±1.3 g/body weight kg/day at the end of 2 months, although within normal range. The results indicate the optimum of 2 hours' biofiltration for uremic patient when treatment is programmed after urea index, Increasing tendnency of PCR must be improved.