In:
Blood Purification, S. Karger AG, Vol. 34, No. 3-4 ( 2012), p. 246-252
Abstract:
〈 b 〉 〈 i 〉 Background: 〈 /i 〉 〈 /b 〉 Accumulation of middle molecules is thought to have adverse effects in patients with acute kidney injury (AKI). Elimination of middle molecules by non-convective means, i.e. hemodialysis, remains difficult. The aim of the study was to investigate the removal characteristics of a new high permeability membrane in AKI patients undergoing extended dialysis (ED). 〈 b 〉 〈 i 〉 Patients and Methods: 〈 /i 〉 〈 /b 〉 We performed a prospective, crossover study comparing the EMiC2 dialyzer (1.8 m 〈 sup 〉 2 〈 /sup 〉 , FMC, Germany) and AV 1000S (1.8 m 〈 sup 〉 2 〈 /sup 〉 , FMC) in 11 critically ill patients with AKI. β 〈 sub 〉 2 〈 /sub 〉 -Microglobulin, cystatin c, creatinine, and urea were measured before and after 0.5, 5.0 and 10 h of ED. Serum reduction ratios, dialyzer clearances, and mass in the total collected dialysate were determined. 〈 b 〉 〈 i 〉 Results: 〈 /i 〉 〈 /b 〉 Dialyzer clearance of β 〈 sub 〉 2 〈 /sub 〉 -microglobulin (EMiC2: 52 ± 1.7 ml/min, AV 1000S: 41.7 ± 1.5 ml/min, p = 0.0002) and cystatin c (EMiC2: 47.2 ± 1.2 ml/min, AV 1000S: 34.2 ± 2.3 ml/min, p 〈 0.0001) was markedly different, as was the reduction of serum levels of β 〈 sub 〉 2 〈 /sub 〉 -microglobulin (EMiC2: 54.3 ± 3.6%, AV 1000S: 39.1 ± 4.5%, p = 0.025) and cystatin c (EMiC2: 38.9 ± 2.6%, AV 1000S: 28.0 ± 3.9%, p = 0.043). Additionally, we observed a higher total amount of these substances in the collected dialysate. There was no significant difference in the total amount of albumin eliminated per treatment. 〈 b 〉 〈 i 〉 Conclusion: 〈 /i 〉 〈 /b 〉 The new EMiC2 dialyzer enhances removal of middle molecules without an increase in albumin loss. The clinical relevance of this finding needs to be determined.
Type of Medium:
Online Resource
ISSN:
0253-5068
,
1421-9735
Language:
English
Publisher:
S. Karger AG
Publication Date:
2012
detail.hit.zdb_id:
1482025-0
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