The evaluation of hemodialysis adequacy during the use of different dialysis membranes

Abstract

Hemodialysis efficacy that significantly influences morbidity and mortality of patients can be evaluated by different widely used indices of adequacy. The aim of the study was to evaluate the adequacy of hemodialysis in the group of patients on maintenance hemodialysis and to examine the influence of different dialysis membranes on the indices of adequacy and frequency of symptoms and complications developing during dialysis treatment. The study involved 14 patients dialyzed in three successive months with three different types of dialyzers: E3 (Hemomed)--cuprophane membrane, 1.3 m2, F6 (Hemomed)--polysulfone membrane, 1.3 m2, CM23 (Zdravlje)--cuprophane membrane, 1.25 m2. Each type of dialyzers was used during one month, meaning during 12 successive 4-hour hemodialyses. Mean value of Kt/V index was 1.39 +/- 0.21 for E3 dialyzer, 1.18 +/- 0.24 for F6 dialyzer and 1.44 +/- 0.25 for CM23 dialyzer. The difference between the indices was statistically significant (p < 0.05). Mean protein catabolic rate (PCRn) ranged between 1.6 and 1.7 and no significant difference was found between the dialyzers used. The frequency of hypertension episodes was similar during the hemodialysis with different dialyzers, but the incidence of different symptoms and hypotension episodes was significantly lower during hemodialysis with polysulfone membrane. Hemodialysis with three examined types of dialyzers enabled acceptable dialysis adequacy. Dialyzers with cuprophane membrane enabled significantly higher Kt/V index, but the incidence of symptoms and hypotension was significantly lower during hemodialysis with polysulfone membrane.