Abstract
Urea & β2, clearances were measured in vitro with bovine blood to evaluate a mid-dilution diafiltration (MD-HDF) technique. Two HF polysulfone dialyzers (F60's) “1” and “2” were connected in series with substitution fluid infused in a mid-dilution mode (i.e. between “1” and “2”). An inter-device dialysate pump was used to set the UF rate in “1” to 25% of Qb. Total fluid filtration rate (Qf) was set to 70–75% of Qb such that TMP(2) = TMP(1). Clearance data was also collected in a) double high flux hemodiafiltration (DHF-HDF) mode in the same configuration without external replacement fluid (i.e. forward filtration in “1” and backfiltration in “2”), and b) parallel dialysis mode. Clearances reported at Qd = 800 ml/min are the average of whole blood clearance and dialysate side clearance, with mass balance errors <10% (urea) and <20% (β2m).TableFor urea, DHF-HDF and MD-HDF showed a 6% (10%) increase over parallel dialysis at Qb=400 (500) ml/min. For β2m, DHF-HDF resulted in a 38% (55%) increase, whereas for MD-HDF, increases were 109% (139%). The dramatic increase in β2m clearance observed with MD-HDF is attributed to the high filtration rate (Qf) achievable with the mid-dilution technique.
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