Oxalate clearance by haemodialysis - a comparison of seven dialysers
Oxalate clearance by haemodialysis - a comparison of seven dialysers
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DOI：
10.1093/ndt/gfh971
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发表时间：
2005-09-01
影响因子：
6.1
通讯作者：
Franssen, CFM
中科院分区：
文献类型：
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作者：
Franssen, CFM
背景在原发性高尿酸（PH）和少尿终末期肾病患者中，草酸盐的清除在很大程度上依赖于透析的清除。关于新型透析器草酸盐清除率的数据很少或不存在。因此，我们测量了一名52岁女性PH患者的7种透析器的草酸盐清除率。由于提倡血液透析滤过（HDF）以增加草酸盐清除率，我们还评估了不同前稀释流量的影响。本研究的目的是选择具有最高草酸盐清除率的透析器和前稀释流量组合。通过在血液透析开始后30、60、120和180 min同时采集传入血液和传出透析液样本来评估草酸盐清除率。血流量和透析液流量分别为350和500 ml/min。所有透析器均在2 I/h的前稀释流量下进行测试。根据透析器的超滤系数，还在4.5 I/h的前稀释流量或无HDF的情况下测试了6个透析器。受试透析器之间的草酸盐清除率存在显著差异，范围为144 +/- 10至220 +/- 12 ml/min。在2 I/h的前稀释流量下，HdF 100 S（219 +/- 10 ml/min）和Sureflux FB-2 IOU（220 12 ml/min）达到最高草酸盐清除率。较高的前稀释流量（2 l/h vs无HDF或4.5 vs 2.0 l/h）产生相似的草酸盐清除率。结论。使用高通量聚砜和具有大表面积的三醋酸纤维素透析器实现了最高的草酸盐清除率。较高的前稀释流量并没有增加草酸清除率。
Background. In patients with primary hyperoxaluria (PH) and oliguric end-stage renal disease, oxalate removal is largely dependent on the clearance by dialysis. Data on the oxalate clearance of newer dialyser types are scarce or absent. Therefore, we measured oxalate clearances of seven dialysers in a single 52-year-old female patient with PH. Since haemodiafiltration (HDF) has been advocated to increase oxalate clearance, we also assessed the effect of different predilution flows. The goal of the study was to select the dialyser and pre-dilution flow combination with the highest oxalate clearance.Methods. Oxalate clearances were assessed by simultaneously taking afferent blood and efferent dialysate samples at 30, 60, 120 and 180 min after the start of haernodialysis. Blood flow and dialysate flow were 350 and 500 ml/min, respectively. All dialysers were tested at a pre-dilution flow of 2 I/h. Six dialysers were also tested at either a pre-dilution flow of 4.5 I/h or without HDF, depending on the ultrafiltration coefficient of the dialyser.Results. Oxalate clearances differed markedly between the tested dialysers, ranging from 144 +/- 10 to 220 +/- 12 ml/min. The highest oxalate clearances were achieved with HdF 100S (219 +/- 10 ml/min) and Sureflux FB-2 IOU (220 12 ml/min) at a pre-dilution flow of 2 I/h. Higher pre-dilution flows (2 l/h vs no HDF or 4.5 vs 2.0 l/h) yielded similar oxalate clearances.Conclusion. The highest oxalate clearances were achieved with a high-flux polysulfone and a cellulose triacetate dialyser with a large surface area. Higher pre-dilution flows did not augment oxalate clearance.