Online hemodiafiltration reduces systemic inflammation compared to low-flux hemodialysis

作者：den Hoedt Claire H^*; Bots Michiel L; Grooteman Muriel P C; van der Weerd Neelke C; Mazairac Albert H A; Penne E Lars; Levesque Renee; ter Wee Piet M; Nube Menso J; Blankestijn Peter J; van den Dorpel Marinus A

来源：Kidney International, 2014, 86(2): 423-432.

DOI：10.1038/ki.2014.9

• hemodiafiltration
• hemodialysis
• inflammation

Online hemodiafiltration may diminish inflammatory activity through amelioration of the uremic milieu. However, impurities in water quality might provoke inflammatory responses. We therefore compared the long-term effect of low-flux hemodialysis to hemodiafiltration on the systemic inflammatory activity in a randomized controlled trial. High-sensitivity C-reactive protein and interleukin-Were measured for up to 3 years in 405 patients of the CONvective TRAnsport STudy, and albumin was measured at baseline and every 3 months in 714 patients during the entire follow-up. Differences in the rate of change over time of C-reactive protein, interleukin-6, and albumin were compared between the two treatment arms. C-reactive protein and interleukin-6 concentrations increased in patients treated with hemodialysis, and remained stable in patients treated with hemodiafiltration. There was a statistically significant difference in rate of change between the groups after adjustments for baseline variables (C-reactive protein difference 20%/year and interleukin-6 difference 16%/year). The difference was more pronounced in anuric patients. Serum albumin decreased significantly in both treatment arms, with no difference between the groups. Thus, long-term hemodiafiltration with ultrapure dialysate seems to reduce inflammatory activity over time compared to hemodialysis, but does not affect the rate of change in albumin.

• 出版日期2014-8