Department of Pediatrics, Faculty of Medicine, Ain Shams University, Cairo, Egypt.
Department of Clinical Pathology & Immunology, Faculty of Medicine, Ain Shams University, Cairo, Egypt.
BMC Nephrol. 2020 Jul 28;21(1):306. doi: 10.1186/s12882-020-01957-9.
Haemodiafilteration (HDF) is a promising new modality of renal replacement therapy (RRT). It is an improvement in the quality of hemodialysis (HD) and thus in the quality of patients'lives. The main obstacle to using HDF is the cost, especially in developing countries. The purpose of this study was to evaluate the benefits of incorporating HDF with different regimens in the treatment of children with end stage renal disease (ESRD).
Thirty-four children with ESRD on regular HD in Pediatric Dialysis Unit, Children's Hospital, Ain Shams University were followed up in 2 phases: initial phase (all patients: HD thrice weekly for 3 months) and second phase, patients were randomized into 2 groups, HDF group and HD group, the former was subdivided into once and twice weekly HDF subgroups. Evaluation using history, clinical and laboratory parameters at 0, 3, 9 and 18 months was carried out.
On short term, we found that the HDF group was significantly superior to HD group regarding all clinical and laboratory parameters. Also, twice HDF subgroup was significantly superior to once HDF subgroup. This was confirmed on long term follow up, but the once HDF proved comparable to twice subgroup.
Incorporating online hemodiafilteration (OL-HDF) in the RRT of children was beneficial in most of the clinical and laboratory parameters measured. It's not all or non; OL-HDF, even once a week, can improve outcomes of HD without significantly affecting the cost.
血液透析滤过（HDF）是一种很有前途的肾脏替代治疗（RRT）新方法。它提高了血液透析（HD）的质量，从而提高了患者的生活质量。使用 HDF 的主要障碍是成本，尤其是在发展中国家。本研究旨在评估在治疗终末期肾病（ESRD）儿童时将 HDF 与不同方案相结合的益处。
在 Ain Shams 大学儿童医院儿科透析科接受常规 HD 治疗的 34 名 ESRD 儿童在两个阶段进行了随访：初始阶段（所有患者：每周 3 次 HD 治疗 3 个月）和第二阶段，患者随机分为 HDF 组和 HD 组，前者进一步分为每周 1 次和 2 次 HDF 亚组。在 0、3、9 和 18 个月时通过病史、临床和实验室参数进行评估。
短期结果表明，HDF 组在所有临床和实验室参数方面均明显优于 HD 组。此外，两次 HDF 亚组明显优于一次 HDF 亚组。长期随访也证实了这一点，但一次 HDF 与两次 HDF 亚组相当。
在儿童的 RRT 中加入在线血液透析滤过（OL-HDF）在大多数测量的临床和实验室参数方面是有益的。OL-HDF 并非全部或非全部；即使每周一次，OL-HDF 也可以改善 HD 的预后，而不会显著增加成本。
