ESPN 51th Annual Meeting

ESPN 2018


 
Residual urine production decreases concentrations of protein-bound uremic toxins more effectively than increased convection with hemodiafiltration
SNAUWAERT EVELIEN 1 VAN BIESEN WIM 1 RAES ANN 1 GLORIEUX GRIET 1 VANDE WALLE JOHAN 1 ROELS SANNE 1 AZUKAITIS KAROLIS 3 BAYAZIT AYSUN 4 CANPOLAT NUR 5 FISCHBACH MICHEL 6 GODEFROID NATHALIE 7 PAGLIALONGA FABIO 8 SCHAEFER FRANZ 9 SPASOJEVIC BRANKICA 10 STEFANIDIS CONSTATINUS J 11 VAN DYCK MARIA 2 ELOOT SUNNY 1 SHROFF RUKSHANA 12

1- GHENT UNIVERSITY, GHENT, BELGIUM
2- LEUVEN UNIVERSITY HOSPITAL, LEUVEN, BELGIUM
3- VILNIUS UNIVERSITY, VILNIUS, LITHUANIA
4- CUKUROVA UNIVERSITY, ADANA, TURKEY
5- CERRAHPASA SCHOOL OF MEDICINE, ISTANBUL
6- CHILDRENS DIALYSIS CENTER, STRASBOURG, FRANCE
7- UNIVERSITé CATHOLIQUE LOUVAIN, BRUSSELS, BELGIUM
8- FONDAZIONE IRCCS CA’ GRANDA OSPEDALE MAGGIORE POLICLINICO, MILAN, ITALY
9- CENTER FOR PEDIATRICS AND ADOLESCENT MEDICINE, HEIDELBERG, GERMANY
10- UNIVERSITY CHILDRENS HOSPITAL, BELGRADE, SERBIA
11- A & P KYRIAKOU CHILDREN’S HOSPITAL, ATHENS, GREECE
12- GREAT ORMOND STREET HOSPITAL FOR CHILDREN NHS FOUNDATION TRUST, LONDON, UK
 
Introduction:

The aim of the study was to compare concentrations of a representative selection of protein-bound uremic toxins (PBUTs) in children on conventional hemodialysis (HD) versus hemodiafiltraton (HDF).

Material and methods:

Of the 101 children (14.7 [11.4; 16.8] years; 51% males) included, all receiving hemodialysis 4 hours 3 weekly, 61 children were on HD and 40 children on HDF. Both groups were age- and gender matched. After following this dialysis modality for a period of one year, total plasma concentrations of PBUTs (p-cresylglucuronide, hippuric acid, indole acetic acid, indoxyl sulfate, p-cresylsulfate, and 3-carboxy-4-methyl-5-propyl-furanpropionic acid) and their %protein binding (%PB) were determined. Multivariate analysis of variance (MANOVA type II) was used to evaluate if the dialysis modality (HD versus HDF) affected the concentrations of the group PBUTs.

Results:

Taking vintage on dialysis and residual urine production (RUP; mL/24h) into account, no differences in PBUT concentrations and %PB were found between children on HD versus HDF. Instead, the PBUT concentrations were predominantly affected by RUP (p=0.04), in which lower concentrations of PBUTs were found in children with a RUP of >500mL/24h. Moreover, no differences in %PB were found between both groups.

Conclusions:

We did not find any differences in concentrations or %PB of PBUTs in children treated with HD compared to HDF. Moreover, we demonstrated that RUP rather than increased convection with HDF has an impact on the concentrations of PBUTs.