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Purpose  To assess the removal performance of low-volume post-hemodiafiltration (HDF) with Japanese hemodiafilters and the removal performance with 20 % reduction in the total dialysate flow rate ( Q  d total).    Methods  Subjects were 8 patients undergoing pre-HDF. Study 1: Post-HDF was performed at a blood flow rate ( Q  b ) of 250 mL/min and a total volume of substitution fluid (Vs) of 12 L/session(s) for 4 hrs using Fineflux-210Seco (FIX), ABH-21PA (ABH), and NVF-21H (NVF). We assessed removal efficiency of small molecular solutes, low-molecular-weight-proteins and the amount of albumin loss. Study 2: Post-HDF was performed at Vs of 12 L/s under G-1,  Q  d total of 500 and  Q  b  of 250 mL/min; G-2,  Q  d total of 400 and  Q  b  of 250 mL/min; and G-3,  Q  d total of 400 and  Q  b  of 300 mL/min. Removal efficiency was compared and analyzed between these conditions.    Results  Study 1: The results using FIX, ABH and NVF are shown in order. The Kt/ V  were 1.8, 1.9 and 1.8. The β 2 -Microglobulin (MG) removal rate (RR) (%) were 81.2, 83.1 and 82.8, and the α 1 -MG RR were 37.4, 40.2 and 38.5, respectively. Study 2: The results in G-1, 2 and 3 are shown in order. The Kt/ V  and the RR of small solutes, were significantly higher in G-3. The β 2 -MG RR (%) were 81.2, 80.1 and 81.0, and the α 1 -MG RR were 37.4, 37.5 and 38.0, respectively.    Conclusions  Low-volume post-HDF performed at  Q  b  of 250 mL/min with Japanese high-performance hemodiafilters exhibited favorable removal efficiency for all solutes. Even with 20 % reduction in  Q  d total, the removal performance was also favorable.

Evaluation of low-volume post-dilution online hemodiafiltration with Japanese high-performance hemodiafilters