Faculty of Medical Sciences, Kragujevac

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Browsing Faculty of Medical Sciences, Kragujevac by Subject "bubrežna dijaliza"

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    Assessment of the influence of expanded hemodialysis on the rate of removal of middle molecular weight uremic toxins
    (Srpsko lekarsko društvo - Okružna podružnica Kragujevac, 2020) Nenadović, Marko; Nikolić, Aleksandra; Kostović, Milica; Drašković, Branislava; Jovanović, Milena; Nikolić, Tomislav; Petrovic, Dejan
    Objective. The aim of this study was to examine the effect of expanded hemodialysis on the degree of b2-microglobulin removal. Methods. Sixteen patients treated with extended MCO hemodialysis were examined. The main parameter for assessing the efficiency of removal of uremic toxins of middle molecular weight is the concentration of b2-microglobulin in the serum before and after a single session of extended MCO hemodialysis. The following were used for statistical analysis: Kolmogorov-Smirnov test, Student's T test for bound samples and Wilcoxon test. Results. Extended MCO hemodialysis effectively removes uremic toxins of middle molecular weight. The reduction index of b2-microglobulin during a single session of extended MCO hemodialysis is 70.60 ± 5.88%. The average loss of albumin during a single session of extended MCO hemodialysis is 1.88 ± 1.02 g/4h, and the index of albumin reduction is 4.94 ± 2.49%. Conclusion. Extended MCO hemodialysis effectively removes b2-microglobulin. The b2-microglobulin reduction index is ~ 71% and the albumin loss is less than 4.0 g/4h. This dialysis modality prevents the development of amyloidosis, atherosclerosis and atherosclerotic cardiovascular diseases in the population of patients treated with regular hemodialysis.
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    Comparison of efficiency of medium molecular weight uremic toxin removal between high-flux hemodialysis and postdilution online hemodiafiltration
    (Srpsko lekarsko društvo - Okružna podružnica Kragujevac, 2021) Nenadović, Marko; Nikolić, Aleksandra; Kostović, Milica; Drašković, Branislava; Jovanović, Milena; Nikolić, Tomislav; Petrovic, Dejan
    Introduction. Conventional high-flux hemodialysis effectively removes uremic toxins of medium molecular weight of 0.5-15 (20) kDa, while postdilution online hemodiafiltration effectively removes uremic toxins of medium molecular weight in the range of 0.5-60 kDa. AIM. The aim of the study was to compare the efficacy of b2-microglobulin removal from the patient serum during a single session of conventional high-flux hemodialysis and postdilution online hemodiafiltration. METHOD. Eighty-five patients treated with conventional high-flux hemodialysis and thirty patients treated with postdilution online hemodiafiltration were examined. The main parameter for assessing the removal efficiency of medium molecular weight uremic toxins was serum b2microglobulin concentration before and after a single session of conventional high-flux hemodialysis and postdilution online hemodiafiltration. The following were used for statistical analysis: Kolmogorov-Smirnov test, Student's T test and Mann-Whitney U test. RESULTS. In patients treated with postdilution online hemodiafiltration, the average total convective volume was 21.38 ± 2.97 liters per session. The b2-microglobulin reduction index for the FX CorDiax 600 dialysis membrane was 61.76 ± 7.32%, while for the FX CorDiax 800 dialysis membrane it was 74.69 ± 6.51%. The albumin reduction index for the FX CorDiax 600 membrane was 3.48 ± 1.28%, and for the FX CorDiax 800 dialysis membrane it was 6.01 ± 2.97%. There is a highly statistically significant difference between the reduction index of b2-microglobulin and albumin, for two different dialysis modalities and two different dialysis membranes (p < 0.01). CONCLUSION. Postdilution online hemodiafiltration is more efficient in removing b2-microglobulin from patient serum, compared to conventional high-flux hemodialysis. Albumin loss during a single session of high-flux hemodialysis is lower compared to a single session of postdilution online hemodiafiltration. With both dialysis modalities, albumin loss is less than 4.0 g/4h. High-flux hemodialysis effectively prevents the development of dialysis-related amyloidosis, while postdilution online hemodiafiltration effectively prevents not only the development of dialysis-related amyloidosis, but also the development of resistance to erythropoietin and atherosclerotic cardiovascular diseases in the population treated with regular dialysis.
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