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Comparison of removal capacity of two consecutive generations of high-flux dialysers during different treatment modalities

Natalie Meert UGent, Sunny Eloot UGent, Eva Schepers UGent, Horst-Dieter Lemke, Annemieke Dhondt UGent, Griet Glorieux UGent, MARIA VAN LANDSCHOOT UGent, MARIA WATERLOOS UGent and Raymond Vanholder UGent (2011) NEPHROLOGY DIALYSIS TRANSPLANTATION. 26(8). p.2624-U1803
abstract
Background. Innovative modifications have been introduced in several types of dialyser membranes to improve adequacy and permselectivity. Which aspects of removal are modified and how this relates to different diffusive or convective strategies has, however, been insufficiently investigated. Methods. In a prospective cross-over study, 14 chronic kidney disease (Stage 5D) patients were dialysed with a second-generation high-flux dialyser (Polynephron (TM)) in comparison to a first-generation type (DIAPES (R)-HF800). Both dialysers were assessed in haemodialysis, in online pre-dilution and in post-dilution haemodiafiltration. Reduction ratio (RR, %) of small water-soluble compounds (urea and uric acid), low-molecular weight proteins (LMWPs) (beta(2)-microglobulin, cystatin C, myoglobin and retinol-binding protein) and protein-bound solutes (hippuric acid, indole acetic acid, indoxylsulphate and p-cresylsulphate) was assessed, together with albumin losses into the dialysate. Results. Comparing the two types of membranes, the second-generation dialyser demonstrated a higher RR for LMWPs, whilst at the same time exhibiting lower albumin losses but only during post-dilution haemodiafiltration. No differences in RR were detected for both the small water-soluble and the protein-bound compounds. Comparing dialysis strategies, convection removed the same amount of solute or more as compared to diffusion. Conclusions. The second-generation membrane resulted in a higher removal of LMWPs compared to the first-generation membrane, but for the other solutes, differences were less prominent. Convection was superior in removal of a broad range of uraemic retention solutes especially with the first-generation membrane.
Please use this url to cite or link to this publication:
author
organization
year
type
journalArticle (original)
publication status
published
subject
keyword
haemodialysis, haemodiafiltration, removal, uraemic toxins
journal title
NEPHROLOGY DIALYSIS TRANSPLANTATION
Nephrol. Dial. Transplant.
volume
26
issue
8
pages
2624 - U1803
Web of Science type
Article
Web of Science id
000293336500033
JCR category
UROLOGY & NEPHROLOGY
JCR impact factor
3.396 (2011)
JCR rank
15/72 (2011)
JCR quartile
1 (2011)
ISSN
0931-0509
DOI
10.1093/ndt/gfq803
language
English
UGent publication?
yes
classification
A1
copyright statement
I have transferred the copyright for this publication to the publisher
id
1997886
handle
http://hdl.handle.net/1854/LU-1997886
date created
2012-01-20 10:29:16
date last changed
2012-02-17 14:59:42
@article{1997886,
  abstract     = {Background. Innovative modifications have been introduced in several types of dialyser membranes to improve adequacy and permselectivity. Which aspects of removal are modified and how this relates to different diffusive or convective strategies has, however, been insufficiently investigated. 
Methods. In a prospective cross-over study, 14 chronic kidney disease (Stage 5D) patients were dialysed with a second-generation high-flux dialyser (Polynephron (TM)) in comparison to a first-generation type (DIAPES (R)-HF800). Both dialysers were assessed in haemodialysis, in online pre-dilution and in post-dilution haemodiafiltration. Reduction ratio (RR, \%) of small water-soluble compounds (urea and uric acid), low-molecular weight proteins (LMWPs) (beta(2)-microglobulin, cystatin C, myoglobin and retinol-binding protein) and protein-bound solutes (hippuric acid, indole acetic acid, indoxylsulphate and p-cresylsulphate) was assessed, together with albumin losses into the dialysate. 
Results. Comparing the two types of membranes, the second-generation dialyser demonstrated a higher RR for LMWPs, whilst at the same time exhibiting lower albumin losses but only during post-dilution haemodiafiltration. No differences in RR were detected for both the small water-soluble and the protein-bound compounds. Comparing dialysis strategies, convection removed the same amount of solute or more as compared to diffusion. 
Conclusions. The second-generation membrane resulted in a higher removal of LMWPs compared to the first-generation membrane, but for the other solutes, differences were less prominent. Convection was superior in removal of a broad range of uraemic retention solutes especially with the first-generation membrane.},
  author       = {Meert, Natalie and Eloot, Sunny and Schepers, Eva and Lemke, Horst-Dieter and Dhondt, Annemieke and Glorieux, Griet and VAN LANDSCHOOT, MARIA and WATERLOOS, MARIA and Vanholder, Raymond},
  issn         = {0931-0509},
  journal      = {NEPHROLOGY DIALYSIS TRANSPLANTATION},
  keyword      = {haemodialysis,haemodiafiltration,removal,uraemic toxins},
  language     = {eng},
  number       = {8},
  pages        = {2624--U1803},
  title        = {Comparison of removal capacity of two consecutive generations of high-flux dialysers during different treatment modalities},
  url          = {http://dx.doi.org/10.1093/ndt/gfq803},
  volume       = {26},
  year         = {2011},
}

Chicago
Meert, Natalie, Sunny Eloot, Eva Schepers, Horst-Dieter Lemke, Annemieke Dhondt, Griet Glorieux, Maria Van Landschoot, Maria Waterloos, and Raymond Vanholder. 2011. “Comparison of Removal Capacity of Two Consecutive Generations of High-flux Dialysers During Different Treatment Modalities.” Nephrology Dialysis Transplantation 26 (8): 2624–U1803.
APA
Meert, N., Eloot, S., Schepers, E., Lemke, H.-D., Dhondt, A., Glorieux, G., Van Landschoot, M., et al. (2011). Comparison of removal capacity of two consecutive generations of high-flux dialysers during different treatment modalities. NEPHROLOGY DIALYSIS TRANSPLANTATION, 26(8), 2624–U1803.
Vancouver
1.
Meert N, Eloot S, Schepers E, Lemke H-D, Dhondt A, Glorieux G, et al. Comparison of removal capacity of two consecutive generations of high-flux dialysers during different treatment modalities. NEPHROLOGY DIALYSIS TRANSPLANTATION. 2011;26(8):2624–U1803.
MLA
Meert, Natalie, Sunny Eloot, Eva Schepers, et al. “Comparison of Removal Capacity of Two Consecutive Generations of High-flux Dialysers During Different Treatment Modalities.” NEPHROLOGY DIALYSIS TRANSPLANTATION 26.8 (2011): 2624–U1803. Print.