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Abstract
<i>Background: </i>Despite increasing knowledge of the uraemic syndrome, both morbidity and mortality remain unacceptably high in patients with chronic kidney disease. <i>Aim of the work: </i>investigate the differences between conventional hemodialysis and hemodiafiltration in the context of chronic kidney disease metabolic bone disease findings serum calcium (sCa), phosphate (sPO4) and intact parathyroid hormone (PTHint) concentrations. <i>Patients and methods: </i>This prospective cross over study was approved by Almaadi hospital committee and included 95 patients with CKD5 on regular hemodialysis for at least 6 months. Patients were divided into two groups: Group A: 60 patients scheduled 6 months conventional high flux (hf-HD) (Period1) followed by 6 months of post-dilutional–HDF (Period2). Group B: (controls) included 35 patients were kept on conventional hf-HD for 12 months. (Period3) for 1<sup>st</sup> 6 months and (Period4) for 2<sup>nd</sup> 6 months. The main variables evaluated at the start as well as at the end of each period were sCa, sPO4 and PTHint. <i>Results: </i>There was highly significant statistical decrease in Phosphorus level in period2 compared to other groups after 2<sup>nd</sup> to 6<sup>th</sup> month and average of overall (p<0.001). A significant statistical decrease was found in Parathormone level and CRP in period2 compared to other groups after 1 month to 6<sup>th</sup> month and average of overall (p<0.05). There was significant statistical decrease in Albumin level in period2 compared to other groups after 2<sup>nd</sup> to 6<sup>th</sup> month and average of overall (p<0.05). There was a significant statistical increase in kt/v in period2 compared to other groups after 1<sup>st</sup> to 6<sup>th</sup> month and average of overall (p<0.05). <i>Conclusion: </i>The switch over from conventional Hf-HD to Ol-HDF results in a significant reduction of both PO4 and PTH concentrations, no significant changes in Ca concentrations.
Highlights
Despite increasing knowledge of the uraemic syndrome, both morbidity and mortality remain unacceptably high in patients with chronic kidney disease (CKD) [1].Secondary hyperparathyroidism which characterized by increased secretion of parathermone (PTH), is one of the major serious complications in patients with CKD on long-term hemodialysis (HD)
There is no significant statistical difference between the four groups as regard Hemoglobin level in the basal (p>0.05), While there is significant statistical increase in Hemoglobin level in period 2 compared to other groupsafter the 1st, 2nd, 3rd, 4th, 5thmonth and average of overall (p
In our study There is no significant statistical difference between the four groups as regard Hemoglobin level in the basal (p>0.05), While there is significant statistical increase in Hemoglobin level in period 2 compared to other groups after the 1st, 2nd, 3rd, 4th, 5th month and average of overall (p
Summary
Despite increasing knowledge of the uraemic syndrome, both morbidity and mortality remain unacceptably high in patients with chronic kidney disease (CKD) [1].Secondary hyperparathyroidism which characterized by increased secretion of parathermone (PTH), is one of the major serious complications in patients with CKD on long-term hemodialysis (HD). Despite increasing knowledge of the uraemic syndrome, both morbidity and mortality remain unacceptably high in patients with chronic kidney disease (CKD) [1]. Despite increasing knowledge of the uraemic syndrome, both morbidity and mortality remain unacceptably high in patients with chronic kidney disease. Results: There was highly significant statistical decrease in Phosphorus level in period compared to other groups after 2nd to 6th month and average of overall (p
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