One Year of Clinical Experience in Postdilution Hemofiltration with Online Reinfusion of Regenerated Ultrafiltrate

Abstract

Background/Aims: Hemofiltrate reinfusion (HFR) is characterized by the use of regenerated ultrafiltrate as replacement fluid. We set up a new technique, postdilution HFR (PD-HFR), aiming at increasing purification efficiency, treatment tolerance and at reducing inflammatory states. Methods: We performed PD-HFR in 6 uremic patients during 1 year. Dialysis efficacy, dialyzer blood loss and the behavior of cytokines were evaluated. Results: No pyrogenic reactions or other adverse events were recorded. Treatment tolerance was excellent. We observed high urea extraction rates and optimal Kt/V values, high β₂-microglobulin (β₂m) extraction rates and a decrease in dialyzer blood loss; also IL-6 and TNF-α decreased significantly. Conclusions: Inversion of the standard HFR configuration has allowed us to improve the removal of both urea and β₂m, and to decrease dialyzer blood loss, with an optimal tolerance. Moreover, the decrease in cytokine levels might attenuate the uremic microinflammatory state.