Comparison between High-flux Hemodialysis and Online Hemodiafiltration as a Renal Replacement Therapy in End Stage Renal Disease Patients as Regards Nutritional Parameters

Abstract

HDF is an extracorporeal renal replacement technique using a highly permeable membrane in which diffusion and convection are conveniently combined to enhance solute removal in a wide spectrum of molecular weights) (Rhonco and Cruz, 2007). UF exceeds the desired fluid loss in the patient, and, therefore, replacement fluid must be administered to achieve the target fluid balance) (Rhonco and Cruz, 2007). Different modalities of HDF are today applied in clinical practice; however, the common denominator of such therapy is the combination of diffusion and convection to achieve solute and volume control.) (S. Van Laecke et al.., 2006). We compared 22 patients on OLHDF with 18 patients on HFHD as regard some nutritional parameters. We found that albumin level was not significantly changed between the two groups but it was more decreased in HFHD group. Nutritional status was not affected in the both groups, as shown by the protein catabolic rate values monitored throughout the study periods There was highly significant decrease in the level of predialytic urea in both groups. Both groups showed no difference as regard weight. There was significant decrease in LDL levels in HDF group at the end of the study but there was no significant difference in delta change of serum LDL between the two groups. Both groups showed no difference as regard HDL, Choletsterol, Triglycerides There was no significant difference as regard intradialytic hypotension between the two groups. Kt/v increased significantly among HDF group. In our study, phosphorus was significantly decreased in both groups after 6 months. calcium was reduced significantly in both groups at the end of the study. In our study, the hemoglobin level did not differ significantly between the two groups, good control of anemia was achieved in both groups at the end of the study. Both two types of dialysis showed perfect control of hyperphosphatemia and anemia which are the two major problems of a dialysis patient.