PMID- 23136214
OWN - NLM
STAT- MEDLINE
DCOM- 20131210
LR  - 20211021
IS  - 1460-2385 (Electronic)
IS  - 0931-0509 (Print)
IS  - 0931-0509 (Linking)
VI  - 28
IP  - 5
DP  - 2013 May
TI  - Multipass haemodialysis: a novel dialysis modality.
PG  - 1255-64
LID - 10.1093/ndt/gfs484 [doi]
AB  - INTRODUCTION: Most home haemodialysis (HD) modalities are limited to home use 
      since they are based on a single-pass (SP) technique, which requires preparation 
      of large amounts of dialysate. We present a new dialysis method, which requires 
      minimal dialysate volumes, continuously recycled during treatment [multipass HD 
      (MPHD)]. Theoretical calculations suggest that MPHD performed six times weekly 
      for 8 h/night, using a dialysate bath containing 50% of the calculated body 
      water, will achieve urea clearances equivalent to conventional HD 4 h thrice 
      weekly, and a substantial clearance of higher middle molecules. METHODS: Ten 
      stable HD patients were dialyzed for 4 h using standard SPHD (dialysate flow 500 
      mL/min). Used dialysate was collected. One week later, an 8-h MPHD was performed. 
      The dialysate volume was 50% of the calculated water volume, the dialysate inflow 
      500 mL/min-0.5 x ultrafiltration/min and the outflow 500 mL/min + 0.5 x 
      ultrafiltration/min. Elimination rates of urea, creatinine, uric acid, phosphate 
      and beta2-microglobulin (B2M) and dialysate saturation were determined hourly. 
      RESULTS: Three hours of MPHD removed 49, 54, 50, 51 and 57%, respectively, of the 
      amounts of urea, creatinine, uric acid, phosphate and B2M that were removed by 4 
      h conventional HD. The corresponding figures after 8 h MPHD were 63, 78, 74, 78 
      and 111%. CONCLUSIONS: Clearance of small molecules using MPHD 6 x 8 h/week will 
      exceed traditional HD 3 x 4 h/week. Similarly, clearance of large molecules will 
      significantly exceed traditional HD and HD 5 x 2.5 h/week. This modality will 
      increase patients' freedom of movement compared with traditional home HD. The new 
      method can also be used in the intensive care unit and for automated peritoneal 
      dialysis.
FAU - Heaf, James Goya
AU  - Heaf JG
AD  - Department of Nephrology B, Herlev Hospital, University of Copenhagen, 
      Copenhagen, Denmark. heaf@dadlnet.dk
FAU - Axelsen, Mette
AU  - Axelsen M
FAU - Pedersen, Robert Smith
AU  - Pedersen RS
LA  - eng
PT  - Journal Article
DEP - 20121107
PL  - England
TA  - Nephrol Dial Transplant
JT  - Nephrology, dialysis, transplantation : official publication of the European 
      Dialysis and Transplant Association - European Renal Association
JID - 8706402
RN  - 0 (Biomarkers)
RN  - 0 (Dialysis Solutions)
RN  - 0 (Phosphates)
RN  - 268B43MJ25 (Uric Acid)
RN  - 8W8T17847W (Urea)
RN  - AYI8EX34EU (Creatinine)
SB  - IM
CIN - Nephrol Dial Transplant. 2013 May;28(5):1067-70. PMID: 23291373
MH  - Adolescent
MH  - Adult
MH  - Biomarkers/*analysis
MH  - Creatinine/analysis
MH  - *Dialysis Solutions
MH  - Female
MH  - Follow-Up Studies
MH  - Humans
MH  - Kidney Failure, Chronic/complications/*therapy
MH  - Male
MH  - Middle Aged
MH  - Models, Theoretical
MH  - Phosphates/analysis
MH  - Prognosis
MH  - *Renal Dialysis
MH  - Ultrafiltration
MH  - Urea/analysis
MH  - Uric Acid/analysis
MH  - Young Adult
PMC - PMC3661003
OTO - NOTNLM
OT  - beta-2 microglobulin
OT  - dialysis adequacy
OT  - home haemodialysis
EDAT- 2012/11/09 06:00
MHDA- 2013/12/16 06:00
PMCR- 2012/11/07
CRDT- 2012/11/09 06:00
PHST- 2012/11/09 06:00 [entrez]
PHST- 2012/11/09 06:00 [pubmed]
PHST- 2013/12/16 06:00 [medline]
PHST- 2012/11/07 00:00 [pmc-release]
AID - gfs484 [pii]
AID - 10.1093/ndt/gfs484 [doi]
PST - ppublish
SO  - Nephrol Dial Transplant. 2013 May;28(5):1255-64. doi: 10.1093/ndt/gfs484. Epub 
      2012 Nov 7.