INDEXES OF ADEQUATE DIALYSIS IN PATIENTS HEMODIALYZED WITH AN-69 MEMBRANE

The objective of this study was to evaluate the incidence of morbidity (at least one hospitalization) during the first twelve months of hemo dialysis (thrice weekly for 4 hours) in 54 (27 males and 27 females) s ex and age matched patients, of whom 32 were treated with AN 69 (M/F = 13/19, 62 +/- 14 years) and 22 with Cuprophan (M/F = 14/8, 61 +/- 14 years). Patients were classified according to the value of TAC urea du ring the period under study: constantly superior or equal to 20 mmol/l iter in Group A (high TAC urea) or inferior to 20 mmol/liter in Group B (low TAC urea). Dialysis quantification (Kt/V) and estimation of the patient's protein catabolic rate (PCR) were based on measurement of t he midweek pre- and post-dialysis blood urea nitrogen. In the patients of Group B, incidence of morbidity was significantly increased when a ge was over 50 years and when AN 69 membrane was used (P < 0.02). Furt hermore, in Group A, the risk of hospitalization was significantly hig her in patients treated by Cuprophan than in those treated by AN 69 (P < 0.02). The survival rate was also studied. Better survival (70%) at four years was observed in patients with high TAC urea who were treat ed by AN 69. The difference was highly significant with the survival r ate (22%) in patients with high TAC urea who were treated by Cuprophan (P < 0.01). Our study suggests that the improvement in morbidity and mortality observed in dialysis patients treated by AN 69 membrane coul d be due either to better epuration of middle molecules with a toxic e ffect on protein metabolism, or to decreased protein catabolism due to less blood-membrane interaction, or to both factors.