Effect Of High-flux Hemodialysis Research Articles

Effect of high-flux hemodialysis plus compound-α Ketoacid tablets under humanistic care on calcium-phosphorus metabolism in uremia patients.

Uremia (UR) is a terminal renal failure manifestation with a very high risk of death, high-flux hemodialysis (HFHD) is currently the most common treatment for UR in clinical practice. In this study, we analysed the therapeutic efficacy of HFHD plus Compound-α Ketoacid Tablets for UR under humanistic care. Firstly, we randomised 100 patients with UR into a research group (RG) for HFHD plus Compound-α Ketoacid Tablets therapy and a control group (CG) for HFHD treatment, with both therapies implemented under humanistic care. By way of comparison, we found that the study group had significantly better renal function after treatment and they had a lower inflammatory response. Also, the study group showed lower calcium and phosphorus metabolism and better immune function. Based on these results, we believe that HFHD + Compound-α Ketoacid Tablets under humanistic care have high clinical value.

Effects of high-flux hemodialysis and hemodiafiltration on the mortality of patients with end-stage kidney disease: a meta-analysis

Background High-flux hemodialysis (HFHD) is widely used in hemodialysis centers and is the mode of hemodialysis actively recommended by the guidelines. Additionally, hemodiafiltration (HDF) is widely used in clinical practice. However, there are some inconsistencies in the results of studies on the effects of HDF and HFHD, which has caused controversy regarding which of these two dialysis modalities to select. Objective To explore the effect of HFHD and HDF on the survival of patients with end-stage kidney disease (ESKD). Methods A systematic search of the PubMed, EMBASE, Cochrane Library, CNKI, Wanfang, and VIP databases was conducted, focusing on cohort studies and randomized controlled trials on hemodialysis in patients with ESKD using HFHD or HDF. A meta-analysis of all-cause mortality and cardiovascular mortality was conducted using Review Manager 5.3 software, and fixed and random effect models were applied according to the heterogeneity results. Results A total of 13 studies, including six cohort studies and seven randomized controlled trials, were included in the final analysis. The results revealed that HFHD had no statistically significant effect on the all-cause mortality (odds ratio (OR): 1.16, 95% confidence interval (CI): 0.86, 1.57) or cardiovascular mortality (OR: 0.86, 95% CI: 0.64, 1.15) of patients with ESKD. However, compared with HDF, HFHD reduced the infection mortality rate (OR: 0.50, 95% CI: 0.33, 0.77). Conclusions Compared with HDF, HFHD has no obvious benefits for all-cause mortality or cardiovascular mortality in patients with ESKD, but reduced risk of infection-related death.

Retracted: Effects of High Flux Hemodialysis Combined with L-Carnitine on Microinflammation and Arteriovenous Fistula in Maintenance Hemodialysis Patients.

[This retracts the article DOI: 10.1155/2022/6964127.].

High-flux Hemodialysis Does Not Increase Vitamin B Loss Compared With Low-flux Hemodialysis

A consistent effect of hemodialysis (HD) on vitamin B loss has not been fully demonstrated and the effect of high-flux hemodialysis (HFHD) is also inconclusive. The aim of this study was to identify the loss of vitamin B1, B3, B5, and B6 in a single HD session and to evaluate the effect of HFHD on vitamin B removal. Patients on maintenance HD were enrolled in this study. They were divided into low-flux hemodialysis (LFHD) group and HFHD group. Vitamin B1, B3, B5, and B6 (pyridoxal 5'-phosphate [PLP]) concentrations in blood pre- and post-HD sessions, as well as in the spent dialysate were measured. Loss of vitamin B was calculated and the difference in vitamin B loss between the 2 groups was compared. The association between HFHD and vitamin B loss was estimated using multivariable linear regression analysis. Seventy-six patients were included, of whom 29 were on LFHD and 47 were on HFHD. The median reduction ratio of serum vitamins B1, B3, B5, and B6 after a single HD session was 38.1%, 24.9%, 48.4%, and 44.7%, respectively. The median concentration of vitamins B1, B3, B5, and B6 in the dialysate was 0.3μg/L, 2.9μg/mL, 2.0μg/L, and 0.4ng/mL. There was no difference in either the reduction ratio of vitamin B in blood, or the concentration in dialysate between LFHD and HFHD groups. After adjusting for covariates by multivariable regression, HFHD had no effect on vitamin B1, B3, B5, or B6 removal. Vitamins B1, B3, B5, and B6 can be removed by HD and HFHD does not increase the loss.

Effect of High Flux Hemodialysis on Patients with Chronic Renal Failure

Effect of High Flux Hemodialysis on Patients with Chronic Renal Failure

Mortality in High-Flux Hemodialysis vs. High-Volume Hemodiafiltration in Colombian Clinical Practice: A Propensity Score Matching Study

Background: The aim was to compare the effects of high-flux hemodialysis (HF-HD) versus high-volume post-dilution hemodiafiltration (HV-HDF) on mortality risk. Methods: Retrospective observational study of prevalent patients on hemodialysis who were followed for two years and treated in 28 kidney centers in Colombia. In this study, we included all adult patients who had been on dialysis for at least 90 days treated with an arteriovenous fistula. They were classified as HF-HD if they underwent this treatment exclusively (100% of time). For HV-HDF, if they received this treatment in more than 90% of the observation period. The primary outcome variable was mortality, and the type of hemodialysis therapy was considered as the exposure variable. Propensity score matching (PSM) and Cox regression models were used to evaluate the effect of dialysis modality on the mortality risk. Results: A total of 2933 patients were analyzed, 2361 patients with HF-HD and 572 with HV-HDF. After PSM, 1010 prevalent patients remained; mortality rate was 14.2% (95% Confidence Interval—CI: 11.3–17.6%) and 5.9% (95%CI: 4.0–8.4%) in HF-HD and HV-HDF group, respectively. HV-HDF therapy was associated with a 55% reduction in mortality compared with the HF-HD group (Hazards ratio-HR: 0.45 [95%CI 0.32–0.64] p < 0.001). Cardiovascular mortality rate was not statistically different between groups (HF-HD: 7.1% (36), HV-HDF: 3.4% (17), HR: 0.51 (95%CI: 0.21–1.28), p: 0.152). However, in patients younger than 60 years, a beneficial effect was observed in favor to HV-HDF therapy with a 79% reduction in cardiovascular mortality risk (HR: 0.21, (95%CI: 0.05–0.79), p: 0.021). Conclusion: After adjustment for different confounders, this study suggests that HV-HDF could reduce all-cause mortality compared to HF-HD therapy in prevalent patients on hemodialysis.

Effect of High Flux Hemodialysis versus Hemodiafiltration on Metabolic Status in Hemodialysis Patients

Background: Hemodiafiltration (HDF) is a newly developed renal replacement therapy blood purification technology with more advantageous effects on hemodynamic stability and better removal of B2 microglobulin and phosphorous Objective: The aim of this study is to compare effect of high flux (HF), low flux (LF) dialysis membranes and hemodiafiltration (HDF) on the metabolic status in hemodialysis patients and quality of life of those patients. Patients and Methods: This study included 60 patients more than18 years old, clinically stable with end stage renal disease on regular HD for at least three years (3 yrs), selected from HD unit in (Kobry El Kobba Military Nephrology Hospital) in the period from March 2018 to September 2018. The patients were divided into three groups equally. Group I: 20 patients on low flux dialyzer, Group II: 20 patients on high flux dialyzer, Group III: 20 patients on hemodiafiltration. Results: There was a highly significant decrease in iPTH, B2 microglobulin and Phosphorous in patients received HDF (363.80±149.04, 8.79±7.22 and 4.31±0.74 respectively in comparison with patients received HF hemodialysis (540.10±242.55, 20.47±3.97and 4.58±1.07 respectively) and patients received LF hemodialysis (725.95±270.01, 36.60±7.22 and 5.73±1.34 respectively).Also, there were a highly significant increase in urea reduction ratio in HDF group compared to HF and LF groups (80.43±7.46, 76.03±9.55 and 65.81±7.42 respectively. Conclusion: Hemodiafiltration is the most effective dialysis technique than high flux and low flux dialysis membrane in removal of medium sized molecule and improvement of quality of life.

The Effect of High-flux Hemodialysis and On-line Hemodiafiltration on Endothelial Function.

The Effect of High-flux Hemodialysis and On-line Hemodiafiltration on Endothelial Function.

Effects of High Flux versus Low Flux on Serum C-Reactive Protein a as an Inflammatory Biomarker in Hemodialysis Patients

Background: Traditional low-flux dialysis cannot improve micro-inflammatory status, while new high-flux dialysis can improve the micro-inflammation and lipid metabolism, it helps to improve the quality of life and survival rate of patients, so how to improve the micro-inflammatory status are a focus for researchers. Objective: was to observe the effect of high flux hemodialysis (HFHD) with Gambro polyflux 170H dialyser and low flux hemodialysis (LFPD) with polyflux 17L dialyser on high-sensitivity C-reactive protein in patients with maintenance hemodialysis. Methods: 60 patients with maintenance hemodialysis were randomly divided into HFHD group and LFHD group. Another 20 cases for physical examinations served as normal control group. The maintenance hemodialysis patients were treated with HFHD using 170H dialyser dliahyser and LFHD using 17L dialyser, three times per week, 4 hours once. After 6 months of the treatment, high-sensitive C-reactive protein was determined in patients as well as normal controls before and after treatment. Results and Conclusion: in two groups, the levels of high-sensitive C-reactive protein before the treatment were higher than normal control (P <0.001). In HFHD group, serum high-sensitive C-reactive protein markedly decreased (P <0.01). In LFHD group, these indices remained unchanged after the dialysis for 6 months. HFHD with 170H polysulfone dialyser is effective in improving micro-inflammation in maintained hemodialysis patients.

The effect of high-flux hemodialysis on the inflammatory factors and serum brain natriuretic in hemodialysis patients with uremia

Objective To investigate the influence of the high-flux hemodialysis (HFD) on inflammatory factors[C-reactive protein (CRP), interleukin-6(IL-6), tumor necrosis factor-α(TNF-α)]and serum brain natriuretic (BNP) in patients before and after hemodialysis. Methods Fifty patients with MHD were enrolled in our hospital in 2013 and divided randomly into HD group (n=25), and HFD group (n=25). Serum CRP, IL-6, TNF-α, and BNP were measured in patients before and after the first hemodialysis session and after the treatment for 6 months later. Results Serum CRP, IL-6, and TNF-α in HD group after the first dialysis session and after the treatment for 6 months were statistically insignificant (P>0.05). In HD group, serum BNP was decreased after the first hemodialysis session and the treatment for 6 months later, the decreases was statistically significant (P 0.05). However, after the 6 mouths, the decreases were statistically significant( P<0.05). Serum BNP was decreased after the first hemodialysis session and the treatment for 6 months later, the decrease was statistically significant(P<0.01). Between two groups, the different time-point and the interaction of two groups and the different time-point, the discrepancy above them were statistically significant(P<0.01). Conclusions The high-flux hemodialysis can eliminate more inflammatory factors such as CRP, IL-6, TNF-α, and serum BNP in patients with uremia. Serum BNP Helps to adjust the dry weight in time, relieve cardiac load and reduce the incidence of heart failure. High-flux hemodialysis is one of the ways of treatment that reduce the morbidity of the heart failure. It can improve prognosis of the patients with MHD. Key words: Renal dialysis; Uremia/TH/ME; C-reactive protein/ME; Interleukin-6/ME; Tumor necrosis factor-alpha/ME; Natriuretic peptide, brain/ME

Effects of high-flux hemodialysis on FGF-23 and micro-inflammatory state in end-stage renal diseases patients

To explore the effects of high-flux hemodialysis (HFHD) on fibroblast growth factor 23 (FGF-23) and micro-inflammatory state in end-stage renal diseases (ESRD) patients to understand the advantages of HFHD in reducing complications in ESRD patients. A total of 60 subjects sheduled for hemodialysis at our hospital in 2012 were randomly divided into two groups of 3-month HFHD and 3-month low-flux hemodialysis (LFHD) (n = 30 each). The levels of serum factors, such as FGF-23, were observed before and after 3-month hemodialysis to evaluate the hemodialysis sufficiency of two groups and analyze the effects of FGF-23 related factors as well as different kinds of hemodialysis on microinflammatory state, biochemical indices and dialysis sufficiency. Before hemodialysis, no intergroup statistical difference (P > 0. 05) existed in age, gender, basic disease, nutrition and levels of hemoglobin (Hb), albumin (ALB), estimated glomerular filtration rate (eGFR), Ca2+,P3- parathyroid hormone (PTIH) and FGF-23 before treatment. After 3-month hemodialysis in two groups, there were a negative correlation between FGF-23, Ca2 + or 1, 25-(OH)2VitD3, a positive correlation between FGF-23 and ALB, P3-, PTH, C-reactive protein (CHRP) or interleukin-6 (IL-6l) and a negative correlation between FGF 23 and HFHD group (P <0. 05) and no significant correlation between FGF-23 and Hb or KT/V (P < 0. 05). Variance analyses were conducted for each factor before and after hemodialysis, indicating that Hb, ALB and Ca2+ significantly increased in both groups after 3-month hemodialysis (P <0. 05) and 1, 25-(OH)2VitD3 significantly elevated in HFHD group (P < 0. 05) but not in LFHD (> 0. 05 . Serum phosphate significantly decreased after 3-month hemodialysis in both groups (P <0. 05) and CHIP, IL-6l, PTH and FGF-23 significantly decreased in HFHD group (P <0. 05), but not in LFHD group (P >0. 05). The levels of P3-, CRP, IL-6, PTH and FGF-23 after 3-month hemodialysis were significantly lower in HFHD group than those in LFHD group (P <0. 05) while the levels of Hb and 1, 25-(OH)2VitD3 after 3-month hemodialysis were significantly elevated in HFHD group compared with those in LFHD group (P < 0. 05). And no significant inter-group difference existed in the levels of Ca2 ALB and KT/V. Compared with LFHD, HFHD is superior in treating anemia and improving nutrition. And HFHD can better decrease FGF-23, correct calcium and phosphorous metabolic disorder and improve micro-inflammatory state.

Hemodialysis: Core Curriculum 2014

From the Division of Nephrology and Hypertension, Vanderbilt University Medical Center, Nashville, TN. Received May 1, 2013. Accepted in revised form July 1, 2013. Originally published online November 21, 2013. Address correspondence to Thomas A. Golper, MD, S3303 Medical Center North, Vanderbilt University Medical Center, 21st Ave S, Nashville, TN 37232. E-mail: thomas.golper@vanderbilt. edu 2013 by the National Kidney Foundation, Inc. 0272-6386/$36.00 http://dx.doi.org/10.1053/j.ajkd.2013.07.028 PRINCIPLES OF DIALYSIS AND HOW MODALITIES DIFFER

Effect of high-flux hemodialysis on nutritional ststus of ESRD patients

Objectives This sduty is in order to observe the effect of high flux hemodialysis on nutritional status of these patients.Methods Assess the nutritional status of patients with scores on subjective assessment of nutritional status(SGA),anthropometric,and biochemical tests,observe the changes of nutritional status after high flux hemodialysis.Results(1)SGA score: no difference between the groups,both A-level,but after the 6 months'high flux hemodialysis treatment,patients chose moreA than before,and a increasing number of patients that selected the significant improvement option ;(2)Anthropometric indicators: For 6 months'high flux dialysis treatment,TSF,MAC measurements increased significantly(P ＜0.05),body weight,BMI,MAMC were no different between the groups,but the classification of malnutrition changed,more moderate malnutrition changed into mild malnutrition;(3)Biochemical detection of indicators: Mter 6 months'high flux dialysis treatment,serum ALB,HDL increased significantly,serum CHOL,LDL decreased significantly(P ＜ 0.05),PAB,TG was no different between the groups,PAB decreased at first,then has a upward trend.Conclusions High-flux hemodialysis can improve nutritional status in uremic patients. Key words: Dialysis; Uremia; Nutritional status

Meeting the challenge of providing adequate haemodialysis

Journal of Renal NursingVol. 4, No. 2 PracticeMeeting the challenge of providing adequate haemodialysisPeter EllisPeter EllisSearch for more papers by this authorPeter EllisPublished Online:29 Sep 2013https://doi.org/10.12968/jorn.2012.4.2.86AboutSectionsView articleView Full TextPDF/EPUB ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareShare onFacebookTwitterLinked InEmail View articleReferencesBhimani JP, Ouseph R and Ward RA (2010) Effect of increasing dialysate flow rate on diffusive mass transfer of urea, phosphate and β2-microglobulin during clinical haemodialysis. Nephrol Dial Transplant 25(12): 3990–5 Crossref, Google ScholarCanaud B, Leray–Moragues H, Kerkeni N, Bosc JY and Martin K (2002) Effective flow performances and dialysis doses delivered with permanent catheters: a 24–month comparative study of permanent catheters versus arterio-venous vascular accesses. Nephrol Dial Transplant 17(7): 1286–92 Crossref, Google ScholarCheung AK, Levin NW, Greene T, Agodoa L, Bailey J et al. (2003) Effects of high-flux hemodialysis on clinical outcomes: results of the HEMO study. J Am Soc Nephrol 14(12): 3251–63 Crossref, Google ScholarEaglestone G, Ellis P (2009) Cystatin C as a marker of renal function in older adults. Nurs Stand 24(13): 35–9 Crossref, Google ScholarEaglestone G, Ellis P (2010) How accurate are single sample iohexol techniques? Journal of Renal Nursing 2(4): 166–71 Link, Google ScholarLocatelli F, Buoncristiani U, Canaud B, Kohler H, Petitclerc T, Zucchelli P (2005) Dialysis dose and frequency. Nephrol Dial Transplant 20(2): 285–96 Crossref, Google ScholarNursing and Midwifery Council (2008) The Code: Standards of conduct, performance and ethics for nurses and midwives. NMC, London Google ScholarRenal Association (2009) Haemodialysis. www.renal.org/Clinical/GuidelinesSection/Haemodialysis.aspx#s5 (accessed 1 March 2012) Google Scholar FiguresReferencesRelatedDetails 1 March 2012Volume 4Issue 2ISSN (print): 2041-1448ISSN (online): 2052-2894 Metrics History Published online 29 September 2013 Published in print 1 March 2012 Information© MA Healthcare LimitedKeywordshaemodialysisdialysis adequacyquality of lifeurea reduction ratiopsychological supportKt/VPDF download

The Effect of High-Flux Hemodialysis on Hemoglobin Concentrations in Patients with CKD

Hemodialysis treatment induces markers of inflammation and oxidative stress, which could affect hemoglobin levels and the response to erythropoietin use. This study sought to determine whether high-flux dialysis would help improve markers of renal anemia, inflammation, and oxidative stress compared with low-flux dialysis. In a prospective, controlled study, 221 patients undergoing maintenance hemodialysis and receiving darbepoetin-alfa treatment (mean age, 66 years; 55% male) from 19 centers were screened in a 20-week run-in period of low-flux hemodialysis with a synthetic dialysis membrane. Thereafter, 166 patients were enrolled and randomly assigned to receive a synthetic high-flux membrane or to continue on low-flux dialysis for 52 weeks. Data on myeloperoxidase, oxidized LDL, high-sensitivity C-reactive protein, and the Malnutrition Inflammation Score were collected at baseline and after 52 weeks; routine laboratory data, such as hemoglobin, ferritin, and albumin, and the use of darbepoetin-alfa, were also measured in the run-in period. Results After 52 weeks, the low-flux and the high-flux groups did not differ with respect to hemoglobin (mean ± SD, 11.7±0.9 g/dl versus 11.7±1.1 g/dl; P=0.62) or use of darbepoetin-alfa (mean dosage ± SD, 29.8±24.8 μg/wk versus 26.0±31.1 μg/wk; P=0.85). Markers of inflammation, oxidative stress, or nutritional status also did not differ between groups. Over 1 year, high-flux dialysis had no superior effects on hemoglobin levels or markers of inflammation, oxidative stress, and nutritional status. These data do not support the hypothesis that enhanced convective toxin removal would improve patient outcome.

Effect of High-Flux Hemodialysis on Delayed Hepatitis B Virus Vaccination Response in Hemodialysis Patients

Objectives: The aim of the study was to evaluate the effect of high-flux (HF) hemodialysis (HD) on delayed protective hepatitis B virus (HBV) antibody seroconversion in HD patients who had no response to the classic third dose of HBV vaccination. Methods: We performed a prospective cohort study. Forty-two patients who did not respond within 6 months after the third dose of the vaccination were enrolled in the study. The patients were randomized to either an HF HD treatment group (n =19) or a conventional HD treatment group (n = 23). Patients' serum hepatitis B surface antibody levels were followed monthly. Results: After 6 months of follow-up, there were 15 (78.9%) patients in HF group and 7 (30.4%) patients in the control group showing delayed HBV vaccination response. The level of antibody titer of HBV vaccination responders was 103.6 ± 48.3 mIU/mL in the HF group and 23.5 ± 15.7 mIU/mL in the control group. The antibody titer did not correlate with sex, age, serum albumin, or hemoglobin in either group. Four patients in control group lost HBV vaccination response > 2 times after 3 months of follow-up, whereas no patients in the HF group lost HBV vaccination response. Conclusion: Hemodialysis patients who do not respond to the classic third dose of HBV vaccination could reobtain a delayed higher protective HBV antibody seroconversion rate by HF HD without other intervention.

The Effect of High-Flux Hemodialysis on Dialysis-Associated Amyloidosis

The Effect of High-Flux Hemodialysis on Dialysis-Associated Amyloidosis

The Effect of High-Flux Hemodialysis on Dialysis-Associated Amyloidosis

Amyloidosis is an important cause of mortality and morbidity in patients with end-stage renal disease (ESRD) undergoing hemodialysis (HD). In this study, depending on the idea that the clearance of middle and high molecular weight toxins could be improved, we aimed to investigate the effect of high-flux dialyzer on clearance of beta-2 microglobulin (β2-MG) and calcium (Ca) phosphorus (P) metabolism in patients under HD treatment. Forty-eight patients with ESRD under chronic HD treatment were included in the study. All patients were randomized into two groups, and HD was performed with low-flux or high-flux dialyzer for 6 months. In the high-flux group, the reduction of β2-MG and P levels during dialysis was significantly higher when compared with the low-flux group (p < 0.001). During the follow-up period, while β2-MG levels decreased significantly in the high-flux group (p < 0.05), there was an increase in the low-flux group (p < 0.05). As a result, our findings suggest that use of high-flux dialyzer can be an efficient alternative in terms of controlling the clearance of β2-MG and impaired Ca and P metabolism. These beneficial effects of high-flux dialyzers are probably mediated by the improved clearance of middle and high molecular weight toxins.

Effects of high-flux hemodialysis on oxidant stress

Neutrophil oxygen radical production is increased in end-stage renal disease (ESRD) patients and it is further enhanced during dialysis with low-flux cellulosic membranes. This increased oxygen radical production may contribute to the protein and lipid oxidation observed in ESRD patients. We tested the hypothesis that high-flux hemodialysis does not increase oxygen radical production and that it is not associated with protein oxidation. Neutrophil oxygen radical production was measured during dialysis with high-flux dialyzers containing polysulfone and cellulose triacetate membranes. Free sulfhydryl and carbonyl groups and advanced oxidation protein products were measured to assess plasma protein oxidation. Pre-dialysis, neutrophil oxygen radical production was significantly greater than normal and increased significantly as blood passed through the dialyzer in the first 30 minutes of dialysis. Post-dialysis, however, neutrophil oxygen radical production had decreased and was not different from normal. Pre-dialysis, significant plasma protein oxidation was evident from reduced free sulfhydryl groups, increased carbonyl groups, and increased advanced oxidation protein products. Post-dialysis, plasma protein free sulfhydryl groups had increased to normal levels, while plasma protein carbonyl groups increased slightly, and advanced oxidation protein products remained unchanged. The results of this study show that neutrophil oxygen radical production normalizes during high-flux dialysis, despite a transient increase early in dialysis. This decrease in oxygen radical production is associated with an improvement in some, but not all, measures of protein oxidation.

Effect of High-Flux Hemodialysis on Cardiac Structure and Function among Patients with End-Stage Renal Failure

The effect of high flux hemodialysis on left ventricular function in ESRD patients was evaluated in a double blind, single cross-over, study comparing conventional to high flux hemodialysis. The subjects were 21 stable chronic hemodialysis patients. Ten were randomly allocated to the conventional-high flux sequence and 11 to the reverse sequence. The conventional membrane was the CD 3,500 or 4,000; the high flux membrane was the Duoflux (Althin Medical Inc., Miami Lakes, Fla.). Both were cellulose acetate and both were sterilized with ethylene oxide. The dialysate bicarbonate and sodium were held constant for the study. The ultrafiltration rates were 3.5-5.0 ml/h/mm Hg transmembrane pressure for the conventional and 15 ml/h/mm for the high flux membrane. The beta-2-microglobulin sieving coefficient was 0 for conventional and 0.27 for the high-flux membrane. The modest improvements in estimates of systolic function suggest a cardiac advantage in high-flux dialysis, the clinical impact of which requires further study.