Abstract

TERRY OSSET, Carmen et al. Comparative study of the efficacy of two online HDF techniques. Rev Soc Esp Enferm Nefrol [online]. 2006, vol.9, n.4, pp.13-17. ISSN 1139-1375.

There are two online haemodiafiltration (HDF) techniques: pre-dilutional and post-dilutional, the latter being the most frequently used. Our study compares the efficacy of two HDF techniques, post-dilutional and mixed, analysing the frequency of cases in which there was an increase in trans-membrane pressure, preventing continuation of the treatment. The study consisted of two phases, in the first phase, (post-dilutional online HDF), we reduced the infusion rate (Qi) every time the trans-membrane pressure (TMP) was ≥ 350 mmHg and we moved on to conventional haemodialysis if Qi was 30 ml/min. In the second phase, (mixed online HDF), we changed to pre-dilutional during the last hour and every time the TMP was ≥ 350 mmHg. In phase 1 haemoconcentration (HC) appeared in 38.83% of sessions and in phase 2 in 18.06%. During the last hour of treatment, HC appeared in 119 cases in phase 1 and in 15 cases in phase 2. Coagulation of the system occurred on 24 occasions during phase 1 and on 2 occasions during phase 2. Hypotension occurred on 80 occasions in phase 1 and on 69 in phase 2. In light of the increase in TMP during post-dilutional HDF, the mixed technique proved more efficient than continuing in post-dilutional with a reduction of Qi. With the mixed method the elimination of de ß2 microglobulin was greater and the efficacy of the technique was not reduced.

Keywords : online haemodiafiltration; trans-membrane pressure; efficacy; haemoconcentration.

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