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Does online hemodiafiltration lead to reduction in trace elements and vitamins?
Author(s) -
CROSS Jennifer,
DAVENPORT Andrew
Publication year - 2011
Publication title -
hemodialysis international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.658
H-Index - 47
eISSN - 1542-4758
pISSN - 1492-7535
DOI - 10.1111/j.1542-4758.2011.00580.x
Subject(s) - medicine , hemodialysis , hemoglobin , micronutrient , selenium , dialysis , albumin , vitamin , urology , chemistry , organic chemistry , pathology
Hemodiafiltration ( HDF ) has been reported to improve nutritional intake, but as it increases convective losses, it could also increase micronutrient loss. We prospectively audited the effect of HDF on vitamin B 12, zinc and selenium. Thirty‐four patients dialyzing ( T / Th / Sa ) switched to HDF , and 44 dialyzing ( M / W / F ) remained on high‐flux hemodialysis ( HD ) and were followed for 12 months. Dialysis adequacy, weight, hemoglobin, and serum albumin did not differ between the groups and did not change over 12 months’ follow up. Similarly, vitamin B 12 did not differ: HDF , 443 (325–682) ng/mL HD vs. 478 (327–690) ng/mL HDF ; 6 months, 513 (351–664) ng/mL vs. 460 (379–647) ng/mL; or 12 months, 444 (317–617) ng/mL vs. 492 (323–644) ng/mL. And no patient had subnormal values. Folate levels, in those not taking supplements, were also stable (start, 6.2 ± 0.7 μg/L HD vs. 7.2 ± 1.0 μg/L HDF ; 12 months, 6.5 ± 0.9 μg/L vs. 10.9 ± 2.4 μg/L). Serum zinc was subnormal in 50% prior to switching to HDF , 10.4 ± 0.4 μmol/L, but did not fall with HDF 10.2 ± 0.3 μmol/L; similarly, selenium was low in 49% prior to switching to HDF , 0.77 ± 0.06 μmol/L, but remained stable on HDF , 0.82 ± 0.06 μmol/L. Although HDF adds convective clearance to standard hemodialysis, it does not lead to a reduction in vitamin B 12, folate, zinc, or selenium. However, half of this dialysis cohort had low levels of both zinc and selenium.