Department of Nephrology, Hospital Clínic Barcelona, Barcelona, Spain.
Blood Purif. 2009;28(3):268-74. doi: 10.1159/000232935. Epub 2009 Aug 14.
As a change from Diapes to polyphenylene membrane in the mid-dilution filter has recently been developed, the aim of this study was to compare mid-dilution using this new dialyzer versus pre- and postdilution. The prospective study included 20 patients who underwent 4 hemodiafiltration (HDF) sessions: 1.7 m(2) polyphenylene and predilution infusion flow (Qi) 200 ml/min, 1.7 m(2) and postdilution Qi 100 ml/min, 1.9 and 2.2 m(2) mid-dilution both with Qi 200 ml/ min. The urea and creatinine reduction ratios were slightly higher in postdilution. The beta(2)-microglobulin (85.8%), myoglobin (73.6%), prolactin (67.8%) and retinol-binding protein (29.2%) reduction ratios with 1.9 m(2) mid-dilution, which was similar to 2.2 m(2) mid-dilution, were significantly higher than with the post- and predilution modes. Mid-dilution appears to be a good HDF alternative that allows a better removal of larger molecules than postdilution and, mainly, predilution. Mid-dilution using 1.9 or 2.2 m(2) dialyzers, at the same convective volume, showed a similar removal.
最近，中稀释过滤器已从 Diapes 改为聚苯并咪唑膜，本研究旨在比较使用这种新透析器的中稀释与预稀释和后稀释。前瞻性研究包括 20 名接受 4 次血液透析滤过（HDF）治疗的患者：1.7 m²聚苯并咪唑膜，预稀释输注流量（Qi）为 200 ml/min，1.7 m²和后稀释 Qi 为 100 ml/min，1.9 和 2.2 m²中稀释，Qi 均为 200 ml/min。后稀释的尿素和肌酐清除率略高。1.9 m²中稀释的β2-微球蛋白（85.8%）、肌红蛋白（73.6%）、催乳素（67.8%）和视黄醇结合蛋白（29.2%）清除率与 2.2 m²中稀释相似，明显高于后稀释和预稀释模式。中稀释似乎是一种很好的 HDF 替代方法，可更好地清除较大分子，优于后稀释，主要优于预稀释。使用 1.9 或 2.2 m²透析器进行中稀释，在相同的对流体积下，清除效果相似。
