High Flux versus Hemodiafiltration in Removal of Indoxyl Sulphate

Abstract

Abstract Background protein-bound compounds such as the p-cresol conjugates p-cresyl sulphate (p-CS) and Indoxyl sulphate (IS) have attracted most interest in recent years due to their poor clearance by conventional dialysis and their potential toxicity. Aim of the Study To compare removal of indoxyl sulphate toxin during single session between low flux, high flux hemodialysis and hemodiafiltration. Methods Cross sectional study was concluded upon 60 randomly selected ESRD patients on regular hemodialysis from nephrology Department in Ain Shams University Hospitals. Serum indoxyl sulphate was measured (pre dialysis and post dialysis) using low flux, high flux hemodialysis and hemodiafiltration. Results 60 test subjects were randomly selected had mean age 43.95 (±11.91 years) in low flux HD group, 48.35 (±13.25 years) in high flux HD group and 45.10 (±18.56 years) in HDF group, were males 66.67 % (n = 40) and females 33.33% (n = 20). The mean indoxyl sulphate reduction ratio using low flux filter was 13.5% (±9.52), using high flux 19.7% (±14.31) and in hemodiafiltration 24.2% (±10.73). There was a statistically significant difference between low flux HD group and HDF group as regard indoxyl sulphate reduction ratio (P value 0.015). There was no statistically significant difference between high flux HD group and HDF group as regard indoxyl sulphate reduction ratio. Conclusion Removal of indoxyl sulphate by hemodiafiltration is higher than hemodialysis using low flux membrane and there is no difference between hemodiafiltration and high flux hemodialysis.