HEMODIAFILTRATION IN 2 CHAMBERS WITHOUT REPLACEMENT FLUID - A CLINICAL-STUDY

Paired filtration dialysis (PFD) is the only hemodiafiltration (HDF) t echnique in which ultrafiltrate (Uf) is obtained continuously with a s imilar composition to plasma. It has been proved that Uf is regenerate d when it passes through an uncoated adsorbent charcoal cartridge: thi s one removes medium-to-large solutes and small toxines (except for ur ea and phosphates), but not the electrolytes and bicarbonate. This reg enerated Uf can be used like replacement fluid, using the same Uf pump as the infusion pump; this makes the HDF technique easier and more re liable. During 12 months (3 h/3 sessions/week), we treated 13 patients with this PFD-Charcoal technique. These patients were previously on c onventional PFD for at least 6 months. The biochemical results were ex cellent with a stabilization of all parameters (urea, creatinine, uric acid, Na, K, Cl, Ca, phosphates, beta(2)-microglobulin, beta(2)M, etc .) and a better control of acidosis (statistically significative after 6 months). The clinical tolerance was also excellent, and the techniq ue was greatly simplified. We conclude that PFD-Charcoal is a good HDF technique that avoids the use of exogenous replacement fluid by using the regenerated Uf itself as an endogenous substitution fluid with bi carbonate.