Comparison of Post- and Pre-dilutional Hemodiafiltration in Hemodialysis Patients
Keywords
Coimriú
Cur síos
1. Study design: randomly assigned, cross-over study.
2. Patient number: 60.
3. Inclusion criteria: stable patients end-stage renal disease who were older than 20 years and received thrice-weekly standard hemodialysis for more than 3 months were recruited.
4. Exclusion criteria: active systemic disease, liver cirrhosis, active malignancy, receiving immunosuppressive treatment, dialysis with temporal non-tunneled catheter, inadequate dialysis dose (single-pooled Kt/V<1.2).
5. Methods:
Prior to randomization, a Charlson Comorbidity Index score and baseline characteristics are recorded for each patient. Each patient who received HDF prior to study will received one-month high-flux hemodialysis with target single-pooled Kt/V>1.2 for washout. The baseline characteristics of each patient including dialyzer, dialysis time, blood flow, dialysate flow, replacement volume, pre- and post-dialysis blood pressure and body weight were recorded. The follow-up laboratory data will also be collected: predialysis C-reactive protein, blood urea nitrogen, creatinine, bicarbonate, sodium, potassium, uric acid, albumin, calcium, phosphate, intact parathyroid hormone, β2-microglobulin, prolactin, fibroblast growth factor 23, α1-microglobulin, indoxyl sulfate, p-cresol sulfate, advance oxidation protein products, advance glycation product, percentage of proinflammatory monocytes; interleukin-6, tumor necrosis factor-α, hematocrit, transferrin saturation and ferritin. Urea kinetics including kt/V, Urea reduction ratio and normalized protein catabolic rate are calculated. We also used Physical Symptoms Distress Scale for life quality measurement.
After randomization, two group received standard prescription of pre- and post-dilution HDF. The prescribed convective volume per treatment of post-dilution mode is based on blood flow, filtration fraction and hematocrit to achieved current recommendation of 23 liter/1.73m2. The convective volume of pre-dilution mode will be at least twice higher than the desired dose in post-dilution mode for each patient. After 3-month stable hemodiafiltration, parameters mentioned above will also be checked. Two group will be switched for another 3-month course and then switch again. The total following time is 12 months.
6. Outcome: The primary objective is to compare the removal of a wide spectrum of solutes such as middle and protein-bound molecules. Secondary outcomes are intradialytic tolerance, including intradialytic hypotension, cramps and arrhythmia, and life quality measurements.
Dátaí
Fíoraithe Deireanach: | 03/31/2019 |
Cuireadh isteach den chéad uair: | 09/14/2017 |
Clárú Measta Curtha isteach: | 09/14/2017 |
Arna chur suas ar dtús: | 09/19/2017 |
Nuashonrú Deireanach Curtha isteach: | 04/21/2019 |
Nuashonrú Deireanach Postáilte: | 04/22/2019 |
Dáta Tosaigh an Staidéir Iarbhír: | 08/31/2017 |
Dáta Críochnaithe Bunscoile Measta: | 10/30/2018 |
Dáta Críochnaithe an Staid Mheasta: | 04/06/2019 |
Coinníoll nó galar
Céim
Critéir Incháilitheachta
Aois Incháilithe le haghaidh Staidéir | 20 Years Chun 20 Years |
Gnéas Incháilithe le haghaidh Staidéir | All |
Modh samplála | Non-Probability Sample |
Glacann Oibrithe Deonacha Sláintiúla | Sea |
Critéir | Inclusion Criteria: - stable patients end-stage renal disease who were older than 20 years and received thrice-weekly standard hemodialysis for more than 3 months were recruited. Exclusion Criteria: - active systemic disease, liver cirrhosis, malignancy, receiving immunosuppressive treatment, dialysis with temporal non-tunneled catheter, inadequate dialysis dose (kt/V<1.2). |
Toradh
Bearta Toraidh Príomhúla
1. Removal of a wide spectrum of solutes [1 years]
Bearta Torthaí Tánaisteacha
1. Intradialytic tolerance [1 years]