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- Title
Superior dialytic clearance of β<sub>2</sub>-microglobulin and p-cresol by high-flux hemodialysis as compared to peritoneal dialysis.
- Authors
Evenepoel, P.; Bammens, B.; Verbeke, K.; Vanrenterghem, Y.
- Abstract
Both residual renal and dialytic clearance confer to the total solute clearance in dialysis patients. Dialytic clearances of the middle molecule beta-microglobulin (β2M) and the protein-bound solute p-cresol (pcr) are generally believed to be higher with peritoneal dialysis (PD) as compared to hemodialysis (HD). Supportive data, however, are lacking. We performed a single-center cross-sectional observational study including 70 unselected patients treated with either high-flux HD (n=20) or PD (n=50). Mid-day serum levels (PD) and time-averaged concentrations (HD) of the water-soluble solutes urea nitrogen, creatinine and phosphate, the middle molecule β2M, and the protein-bound solute pcr were determined. Dialytic solute clearances (l/week/1.73 m2) were calculated from total dialysate collection during the mid-week session in HD and 24 h dialysate collection in PD. Renal clearances were calculated for each of the respective solutes from a timed urine collection. Total clearances were obtained by summation. HD delivered significantly higher clearances of all retention solutes studied. This superiority was especially pronounced for pcr (30.9±62.7 vs 4.4±2.3, HD vs PD, P<0.0001) and β2M (28.6±6.6 vs 5.8±3.1, HD vs PD, P<0.0001). Renal clearances, conversely, were significantly higher in patients on PD. Serum levels of all solutes but pcr were significantly lower in HD than in PD. Both a higher residual renal function and a lower generation rate contribute to the lower pcr levels in PD. In conclusion, superior dialytic clearance of both water-soluble solutes, β2M, and pcr is achieved by high-flux HD as compared to PD.Kidney International (2006) 70, 794–799. doi:10.1038/sj.ki.5001640; published online 5 July 2006
- Subjects
HEMODIALYSIS; PERITONEAL dialysis; CREATININE; PHOSPHATES; KIDNEY diseases; IMMUNOGLOBULINS
- Publication
Kidney International, 2006, Vol 70, Issue 4, p794
- ISSN
0085-2538
- Publication type
Article
- DOI
10.1038/sj.ki.5001640