ADEQUACY OF DIALYSIS PRESCRIPTION IN HEMO DIALYSIS AND 3 DIFFERENT MODALITIES OF HEMODIAFILTRATION

The aim of this study was to survey adequacy of dialysis prescription with hemodialysis (HD) and different modalities of hemodiafiltration ( HDF) and treatment outcomes in Spain. A questionaire of dialysis presc ription was send to all National dialysis units. A total of 3361 quest ionaires of patients on maintenance dialysis were received. To be incl uded into the study: age, time on dialysis, lenght of dialysis in hour s/week, blood flow, type of dialyzer, mid-week BUN pre and post-dialys is, potassium, phosphorus, creatinine, hemoglobin, weight, height and number of days of hospitalization/year were required. Only 2282 who fu lfilled all criteria were selected. Kt/V and pcr (corrected by residua l renal function), TAC and body surface area were calculated. The pati ents were treated with HD (n = 2112): 1125 with Acetate (HDAc) and 987 with Bicarbonate (HDBi); and HDF (n = 170): 103 in Biofiltration (BIO ), 33 in Acetate-free BIO (AFB) and 34 in Paired Filtration Dialysis ( PFD). The patients treated with HDBi were older than HDAc, AFB and PFD . Time on dialysis was slightly increased in patients on HDBi when it was compared to HDAc. The length of dialysis was higher in HD (>10.6 h ours) versus HDF (< 9.5 hours, p < 0.001). Kt/V and pcr were higher in AFB patients. There was a significant increase of Kt/V in HDBi and BI O in comparison to HDAc and PFD (p < 0.05). The pcr was lower in HDAc than in HDBi (p < 0.05). A significant decrease in mean arterial press ure during the dialysis procedure was observed in both types of HD (p < 0.05), remaining stable in the three different HDF modalities. The m orbidity rate was similar in all procedures evaluated. These data sugg est that the different modalities of HDF evaluated provide an adequate therapy, with a significant reduction in the length of dialysis and a better cardiovascular tolerance.