P1099EVALUATION OF THE DEPURATION OF SOLUTES IN THE MIDDLE TO HIGH MOLECULAR WEIGHT RANGE WITH DIFFERENT TECHNIQUES OF HAEMODIALYSIS

Abstract

Abstract Background and Aims Haemodialysis is the most commoly used replacement therapy for chronic kidney disease. We are looking for new solutions to remove solutes in the middle to high molecular weight range. Our objective is to evaluate and compare the purification of small and middle to high molecular weight between 15-45 KDa with Haemodyafiltration On Line postdilutional (HDF-OL-post) technique, Haemodialysis High-Flux (HD-HF) and Haemodialysis Expanded (HDx) using specific high permeability membranes: in the first two techniques polyphenylene membranes (1.7m2) and in the HDx technique cut point membranes PAEs/PVP (1.7 m2). Method 10 chronic prevalent patients on haemodialysis, older than 18 years, without diuresis and stable, 60% males. Mean age 65.3±17.47 years. Time in HD, mean 49.5 months. Etiologies: 20% NAE, 30% ND, 10 % Glomerulopathies, 40% unaffiliated. Vascular Accesses: 50% FAVn, 20% FAVp, 30% CVC-T. They were evaluated for three consecutive weeks with analytics in the intermediate session, modifying the technique and the membrane, keeping the dialysis patient stable. Post-dialysis concentrations of solutes in the middle to high molecular weight range were corrected in relation to haemoconcentration. A comparison of the reduction percentages (RP%) of various molecules was performed. The possible normal distribution was studied in the continuous variables with the Shapiro-Wilk test and the comparison of means using the t-Student or Wilconson test as the most appropriate. SPSS statistical program 17.0. Results No serious adverse events or allergies were recorded. The comparative results between the three techniques are shown in the figure 1. Conclusion The mean reduction of medium molecules (β2-microglobulin, cystatin-C) was not lower in HDx compared to HDF-OL-post. From 20 KDa there is no greater capacity to reduce solutes in HDx in our sample than in the other techniques. Between the three techniques, the HDF-Ol-post is the one that shows a higher percentage of mean reduction of α1-acid glycoprotein and albumin.