Department of Internal Medicine, Hanyang University College of Medicine, Seoul, Korea.
Kidney Res Clin Pract. 2013 Jun;32(2):62-5. doi: 10.1016/j.krcp.2013.04.007. Epub 2013 May 22.
Because hemodiafiltration (HDF) involves large amounts of ultra-filtration and substitution fluid infusion, its effects on serum electrolytes may be different from those of hemodialysis (HD). Serum sodium and blood pressures were compared between patients undergoing online HDF and high-flux HD (HFHD).
Thirty-two of 101 patients on HFHD switched voluntarily to online HDF. Their pre- and postdialysis serum measurements were compared with those of the remaining 69 HFHD patients.
Online HDF patients had lower pre- and postdialysis systolic blood pressures (SBPs) than HFHD patients (predialysis, 136±21 vs. 145±19 mmHg, P<0.05; postdialysis, 129±22 vs. 142±25 mmHg, P<0.05). Pre- and postdialysis serum sodium concentrations were not significantly different between online HDF and HFHD (predialysis, 138±2 vs. 137±3 mEq/L; postdialysis, 134±2 vs. 134±2 mEq/L). However, the change in serum sodium concentration after dialysis was greater in online HDF than HFHD patients (-3.7±2.2 vs. -2.5±2.8 mEq/L, P<0.05). The change in serum sodium concentration was correlated with postdialysis SBP (r=0.304, P<0.005) and pulse pressure (r=0.299, P<0.005). Predialysis SBP (r = 0.317, P<0.005) and pulse pressure (r=0.324, P=0.001) were also correlated with the postdialysis serum sodium change.
Compared with HFHD, online HDF has a greater serum sodium lowering effect. This might contribute to the ability of online HDF to stabilize both pre- and postdialysis SBP.
由于血液透析滤过（HDF）涉及大量的超滤液和置换液输注，其对血清电解质的影响可能与血液透析（HD）不同。比较了接受在线 HDF 和高通量 HD（HFHD）治疗的患者的血清钠和血压。
101 例 HFHD 患者中有 32 例自愿转为在线 HDF，比较其透析前后的血清测量值与其余 69 例 HFHD 患者的测量值。
在线 HDF 患者的透析前和透析后的收缩压（SBP）均低于 HFHD 患者（透析前，136±21 与 145±19mmHg，P<0.05；透析后，129±22 与 142±25mmHg，P<0.05）。在线 HDF 和 HFHD 患者透析前后血清钠浓度无显著差异（透析前，138±2 与 137±3mEq/L；透析后，134±2 与 134±2mEq/L）。然而，在线 HDF 患者透析后血清钠浓度的变化大于 HFHD 患者（-3.7±2.2 与-2.5±2.8mEq/L，P<0.05）。血清钠浓度的变化与透析后 SBP（r=0.304，P<0.005）和脉压（r=0.299，P<0.005）相关。透析前 SBP（r=0.317，P<0.005）和脉压（r=0.324，P=0.001）也与透析后血清钠的变化相关。
与 HFHD 相比，在线 HDF 具有更大的降低血清钠的作用。这可能有助于在线 HDF 稳定透析前后的 SBP。
