RECOMBINANT-HUMAN-ERYTHROPOIETIN AND HIGH-FLUX HEMODIAFILTRATION

Since 1982, 32 uraemic patients were treated in our institution by hig h flux haemodiafiltration (H-HDF) in order to shorten significantly th e dialytic treatment session. H-HDF used a high surface area filter (1 .4-1.9 m(2)) with high hydraulic permeability (polyacrylonitrile and p olysulfone), at high blood flow (450 ml/min) and high rates of reinfus ion of substitution fluid (22 1/session). In this way the dialytic ses sion was shortened to 140+/-19 min, maintaining a good cardiovascular stability and high dialytic efficiency (Kt/V>1.1). Human recombinant e rythropoietin rHuEpo introduced in the therapy of this group in 1987 h as resulted in an improvement of renal anaemia, but also a prolongatio n of the time of dialytic treatment due to a decrease in the efficienc y of filters. During the period of the study, the treatment time incre ased from 140+/-19 min to 168+/-25 min with a concomitant increase of haematocrit and haemoglobin (from 24% to 36% and from 7.9 to 10.5 g/dl , respectively). H-HDF maintains a noticeable increase in dialytic eff icacy with good cardiovascular stability, but the goal of a significan t reduction in the time of treatment can no longer be obtained.