Premium
Centralized On‐Line Hemodiafiltration System Utilizing Purified Dialysate as Substitution Fluid
Author(s) -
Sato Takashi,
Koga Nobuhiko
Publication year - 1998
Publication title -
artificial organs
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.684
H-Index - 76
eISSN - 1525-1594
pISSN - 0160-564X
DOI - 10.1046/j.1525-1594.1998.05085.x
Subject(s) - hemodialysis , chromatography , dialysis , detection limit , chemistry , medicine , surgery
We followed the guidelines of the Kyushu Society for Hemodiafiltration (HDF) Therapy on the purification of dialysate used as substitution fluid and clinically applied HDF using only 20 L or 15 L of substitution fluid in the pre‐ or postdilution mode, respectively. We used a centralized on‐line HDF system consisting of a novel multi‐patient dialysate delivery system applying 3 endotoxin (ET) removal filters in series, maintaining the ET level within the criteria limit below 1.0 IU/L (measured at the first filter outlet to be 0.1 IU/L and after the third filter to be below the sensitivity limit) irrespective of the fluctuation in the ET level of the tap water. Low molecular weight proteins (β 2 ‐microglobulin, prolactin, α 1 ‐micro‐globulin, and α1‐acid glycoprotein) were more effectively removed in this HDF system than in conventional hemodialysis (HD) using the same dialyzer as that in the HDF system, and the removal of these proteins in the HDF system was enhanced as their molecular weights increased. The clinical effect of the HDF system was demonstrated by a decrease in joint pain accompanied by improvement in joint motion in 6 dialysis patients followed over the long term (100 weeks).