#721 Removal of middle molecules with hemoadsorption plus hemodiafiltration in kidney failure patients

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Abstract Background and Aims Hemodiafiltration (HDF) promotes a higher clearance of middle molecules than hemodialysis. Whether the association of hemoadsorption plus HDF (HAHDF) using cartridges with styrene-divinylbenzene further enhances the removal of middle molecules is yet to be defined. We prospectively analyzed the removal of middle molecules in four patients undergoing HAHDF and compared it with HDF. Method Patients underwent 3-hour sessions of HAHDF with post-filter replacement or the HDF with same parameters. We measured the reduction ratio (RR) [i.e., 1 – (pre-session/post-session)] of four middle molecules in all sessions. Results Four patients performed 29 sessions of HAHDF and 17 sessions of HDF. The main characteristics of the 46 sessions were blood flow of 400 mL/min (IQR 350–400 mL/min), convective post-filter flow of 115 mL/min (IQR 105–115), and dialysate flow of 500 mL/min (IQR 500–800 mL/min). The RR of ß2-microglobulin (12 kDa), myoglobin (17 kDa), and prolactin (23 kDa), were higher with HAHDF. The RR of parathormone (9.4 kDa) was equivalent. Conclusion 3-hour HAHDF sessions provide a superior reduction ratio of three middle molecules compared to HDF.

Ce résumé expose les affirmations des auteurs. BNTIC ne l’interprète pas comme une validation indépendante des résultats.