Effect of High Volume Hemodiafiltration on Secondary Hyperparathyroidism Among Hemodialysis Patients

Ezzat Abdalrahman El Etreby; Mohamed Said El-Shorbagy; Al-Sayed Mohamed Rashed; Ahmed Mohamed Alsawy

doi:doi:10.11648/j.sjcm.20211003.12

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Effect of High Volume Hemodiafiltration on Secondary Hyperparathyroidism Among Hemodialysis Patients

Ezzat Abdalrahman El Etreby, Mohamed Said El-Shorbagy, Al-Sayed Mohamed Rashed, Ahmed Mohamed Alsawy

Published in Science Journal of Clinical Medicine (Volume 10, Issue 3)

Received: 14 May 2021 Accepted: 12 July 2021 Published: 28 October 2021

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Abstract

Background: Despite increasing knowledge of the uraemic syndrome, both morbidity and mortality remain unacceptably high in patients with chronic kidney disease. Aim of the work: investigate the differences between conventional hemodialysis and hemodiafiltration in the context of chronic kidney disease metabolic bone disease findings serum calcium (sCa), phosphate (sPO4) and intact parathyroid hormone (PTHint) concentrations. Patients and methods: This prospective cross over study was approved by Almaadi hospital committee and included 95 patients with CKD5 on regular hemodialysis for at least 6 months. Patients were divided into two groups: Group A: 60 patients scheduled 6 months conventional high flux (hf-HD) (Period1) followed by 6 months of post-dilutional–HDF (Period2). Group B: (controls) included 35 patients were kept on conventional hf-HD for 12 months. (Period3) for 1^st 6 months and (Period4) for 2^nd 6 months. The main variables evaluated at the start as well as at the end of each period were sCa, sPO4 and PTHint. Results: There was highly significant statistical decrease in Phosphorus level in period2 compared to other groups after 2^nd to 6^th month and average of overall (p<0.001). A significant statistical decrease was found in Parathormone level and CRP in period2 compared to other groups after 1 month to 6^th month and average of overall (p<0.05). There was significant statistical decrease in Albumin level in period2 compared to other groups after 2^nd to 6^th month and average of overall (p<0.05). There was a significant statistical increase in kt/v in period2 compared to other groups after 1^st to 6^th month and average of overall (p<0.05). Conclusion: The switch over from conventional Hf-HD to Ol-HDF results in a significant reduction of both PO4 and PTH concentrations, no significant changes in Ca concentrations.

Published in	Science Journal of Clinical Medicine (Volume 10, Issue 3)
DOI	10.11648/j.sjcm.20211003.12
Page(s)	78-84
Creative Commons	This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.
Copyright	Copyright © The Author(s), 2021. Published by Science Publishing Group

Keywords

High Volume Hemodiafiltration, Secondary Hyperparathyroidism, Hemodialysis Patients

References

[1]	Tattersall JE, Ward RA (2013). Online haemodiafiltration: definition, dose quantification and safety revisited. Nephrol Dial Transplant; 28: 542–50.
[2]	Locatelli F, Altieri P, Andrulli S, et al. (2010): Hemofiltration and hemodiafiltration reduce intradialytic hypotension in ESRD. J Am SocNephrol.; 21: 1798–1807.
[3]	Lornoy W, Becaus I, Billiouw JM, et al. (2000): On-line haemodiafiltration: remarkable removal of β2-microglobulin. Long-term clinical observations. Nephrol Dial Transplant; 15 (Suppl. 1): 49–54.
[4]	Marcelli D, Scholz C, Ponce P, et al. (2015): High-Volume PostdilutionHemodiafiltration Is a Feasible Option in Routine Clinical Practice. Artificial Organs, 39 (2): 142–149.
[5]	Ledebo I, Blankestijn PJ (2010). Haemodiafiltration-optimal efficiency and safety. NDT Plus; 3: 8–16.
[6]	Mostovaya I M, Muriel P. C, Grooteman, et al. (2015): High convection volume in online post-dilution haemodiafiltration: relevance, safety and costs Clinical Kidney Journal. 8, (4): 368–373.
[7]	Leurs P, Lindholm B, Stenvinkel P (2013). Effects of hemodiafiltration on uremic inflammation. Blood Purif.; 35 Suppl 1: 11–7. doi: 10.1159/000346359.
[8]	Luciano A. Pedrini, Adam M. Zawada, Anke C. Winter, et al. (2019): Effects of high-volume online mixed-hemodiafiltration on anemia management in dialysis patients. https://doi.org/ 10.1371/journal.pone.0212795.
[9]	Maduell F, Javier Varas, Rosa Ramos, et al. (2017): Hemodiafiltration Reduces All-Cause and Cardiovascular Mortality in Incident Hemodialysis Patients: A Propensity-Matched Cohort Study. Am J Nephrol; 46: 288–297.
[10]	EzioMovilli, CorradoCamerini, Paola Gaggia, etal. (2011): Effect of post-dilutional on-line haemodiafiltration on serum calcium phosphate and parathyroid hormone concentrations in uraemic patients. Nephrol Dial Transplant 26: 4032–4037.
[11]	Guillaume Jean, Jean-Marc Hurot, PatrikDeleaval, et al. (2015): Online-haemodiafiltration vs. conventional haemodialysis: a cross-over study. Jean, et al. BMC Nephrology 16: 70.
[12]	Davenport A, Gardner C, Delaney M; Pan Thames Renal Audit Group (2010): The effect of dialysis modality on phosphate control: haemo-dialysis compared to haemodiafiltration. The Pan Thames Renal Audit. Nephrol Dial Transplant; 25: 897–901.
[13]	Vilar E, Fry AC, Wellsted D, et al. (2009): Long-term outcomes in online hemodiafiltration and high-flux hemodialysis: a comparative analysis. Clin J Am SocNephrol; 4: 1944-1953.
[14]	Kovesdy CP, Ahmadzadeh S, Anderson JE, et al. (2008): Secondary hyperparathyroidism is associated with higher mortality in men with moderate to severe chronic kidney disease. Kidney Int; 73 (11): 1296–302.
[15]	Vega A, Quiroga B, Abad S, et al. (2015): Albumin leakage in online hemodiafiltration, more convective transport, more losses? TherApher Dial. 19 (3): 267–71.
[16]	Fournier A, Birmele B, Francois M, et al. (2015): Factors associated with albumin lossin post-dilution hemodiafiltration and nutritional consequences. Int J Artif Organs. 38 (2): 76–82.
[17]	Bazeley J, Bieber B, Li Y, et al. (2011): C-reactive protein and prediction of 1-year mortality in prevalent hemodialysis patients. Clin J Am SocNephrol; 6: 2452-2461.
[18]	Penne EL, Visser L, van den Dorpel MA, et al. (2009): Microbiological quality and quality control of purified water and ultrapure dialysis fluids for online hemodiafiltration in routine clinical practice. Kidney Int 76: 665-672.
[19]	Claire H. den Hoedt, Michiel L. Bots, Muriel P. C. Grooteman (2014). Online hemodiafiltration reduces systemic inflammation compared to low-flux hemodialysis.
[20]	Ping Jia, Wei Jin, JieTeng, et al. (2016): Acute Effects of HemodiafiltrationVersus Conventional Hemodialysis on Endothelial Function and Inflammation, A Randomized Crossover Study. Medicine _ Volume 95, Number 16.
[21]	Grit Waitz, Jürgen Bock, Peter Ahrenholz, et al. (2018): Albumin/ C-reactive protein ratio in the treatment of patients with chronic kidney disease - high flux hemodialysis vs. online hemodiafiltration. https://doi.org/10.1093/ndt/gfy104.FP463.
[22]	Francesco Locatelli, Angelo Karaboyas, Ronald L. Pisoni (2018). Mortality risk in patients on hemodiafiltration versus hemodialysis: a ‘real-world’ comparison from the DOPPS. Nephrol Dial Transplant 33: 683–689.

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APA Style

Ezzat Abdalrahman El Etreby, Mohamed Said El-Shorbagy, Al-Sayed Mohamed Rashed, Ahmed Mohamed Alsawy. (2021). Effect of High Volume Hemodiafiltration on Secondary Hyperparathyroidism Among Hemodialysis Patients. Science Journal of Clinical Medicine, 10(3), 78-84. https://doi.org/10.11648/j.sjcm.20211003.12

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ACS Style

Ezzat Abdalrahman El Etreby; Mohamed Said El-Shorbagy; Al-Sayed Mohamed Rashed; Ahmed Mohamed Alsawy. Effect of High Volume Hemodiafiltration on Secondary Hyperparathyroidism Among Hemodialysis Patients. Sci. J. Clin. Med. 2021, 10(3), 78-84. doi: 10.11648/j.sjcm.20211003.12

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AMA Style

Ezzat Abdalrahman El Etreby, Mohamed Said El-Shorbagy, Al-Sayed Mohamed Rashed, Ahmed Mohamed Alsawy. Effect of High Volume Hemodiafiltration on Secondary Hyperparathyroidism Among Hemodialysis Patients. Sci J Clin Med. 2021;10(3):78-84. doi: 10.11648/j.sjcm.20211003.12

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@article{10.11648/j.sjcm.20211003.12,
  author = {Ezzat Abdalrahman El Etreby and Mohamed Said El-Shorbagy and Al-Sayed Mohamed Rashed and Ahmed Mohamed Alsawy},
  title = {Effect of High Volume Hemodiafiltration on Secondary Hyperparathyroidism Among Hemodialysis Patients},
  journal = {Science Journal of Clinical Medicine},
  volume = {10},
  number = {3},
  pages = {78-84},
  doi = {10.11648/j.sjcm.20211003.12},
  url = {https://doi.org/10.11648/j.sjcm.20211003.12},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.sjcm.20211003.12},
  abstract = {Background: Despite increasing knowledge of the uraemic syndrome, both morbidity and mortality remain unacceptably high in patients with chronic kidney disease. Aim of the work: investigate the differences between conventional hemodialysis and hemodiafiltration in the context of chronic kidney disease metabolic bone disease findings serum calcium (sCa), phosphate (sPO4) and intact parathyroid hormone (PTHint) concentrations. Patients and methods: This prospective cross over study was approved by Almaadi hospital committee and included 95 patients with CKD5 on regular hemodialysis for at least 6 months. Patients were divided into two groups: Group A: 60 patients scheduled 6 months conventional high flux (hf-HD) (Period1) followed by 6 months of post-dilutional–HDF (Period2). Group B: (controls) included 35 patients were kept on conventional hf-HD for 12 months. (Period3) for 1st 6 months and (Period4) for 2nd 6 months. The main variables evaluated at the start as well as at the end of each period were sCa, sPO4 and PTHint. Results: There was highly significant statistical decrease in Phosphorus level in period2 compared to other groups after 2nd to 6th month and average of overall (pth month and average of overall (pnd to 6th month and average of overall (pst to 6th month and average of overall (pConclusion: The switch over from conventional Hf-HD to Ol-HDF results in a significant reduction of both PO4 and PTH concentrations, no significant changes in Ca concentrations.},
 year = {2021}
}

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TY  - JOUR
T1  - Effect of High Volume Hemodiafiltration on Secondary Hyperparathyroidism Among Hemodialysis Patients
AU  - Ezzat Abdalrahman El Etreby
AU  - Mohamed Said El-Shorbagy
AU  - Al-Sayed Mohamed Rashed
AU  - Ahmed Mohamed Alsawy
Y1  - 2021/10/28
PY  - 2021
N1  - https://doi.org/10.11648/j.sjcm.20211003.12
DO  - 10.11648/j.sjcm.20211003.12
T2  - Science Journal of Clinical Medicine
JF  - Science Journal of Clinical Medicine
JO  - Science Journal of Clinical Medicine
SP  - 78
EP  - 84
PB  - Science Publishing Group
SN  - 2327-2732
UR  - https://doi.org/10.11648/j.sjcm.20211003.12
AB  - Background: Despite increasing knowledge of the uraemic syndrome, both morbidity and mortality remain unacceptably high in patients with chronic kidney disease. Aim of the work: investigate the differences between conventional hemodialysis and hemodiafiltration in the context of chronic kidney disease metabolic bone disease findings serum calcium (sCa), phosphate (sPO4) and intact parathyroid hormone (PTHint) concentrations. Patients and methods: This prospective cross over study was approved by Almaadi hospital committee and included 95 patients with CKD5 on regular hemodialysis for at least 6 months. Patients were divided into two groups: Group A: 60 patients scheduled 6 months conventional high flux (hf-HD) (Period1) followed by 6 months of post-dilutional–HDF (Period2). Group B: (controls) included 35 patients were kept on conventional hf-HD for 12 months. (Period3) for 1st 6 months and (Period4) for 2nd 6 months. The main variables evaluated at the start as well as at the end of each period were sCa, sPO4 and PTHint. Results: There was highly significant statistical decrease in Phosphorus level in period2 compared to other groups after 2nd to 6th month and average of overall (pth month and average of overall (pnd to 6th month and average of overall (pst to 6th month and average of overall (pConclusion: The switch over from conventional Hf-HD to Ol-HDF results in a significant reduction of both PO4 and PTH concentrations, no significant changes in Ca concentrations.
VL  - 10
IS  - 3
ER  -

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Author Information

Ezzat Abdalrahman El Etreby

Department of Internal Medicine and Nephrology, Department of Clinical Pathology, Faculty of Medicine, Al Azhar University, Cairo, Egypt
Mohamed Said El-Shorbagy

Department of Internal Medicine and Nephrology, Department of Clinical Pathology, Faculty of Medicine, Al Azhar University, Cairo, Egypt
Al-Sayed Mohamed Rashed

Department of Internal Medicine and Nephrology, Department of Clinical Pathology, Faculty of Medicine, Al Azhar University, Cairo, Egypt
Ahmed Mohamed Alsawy

Department of Internal Medicine and Nephrology, Department of Clinical Pathology, Faculty of Medicine, Al Azhar University, Cairo, Egypt

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Ezzat Abdalrahman El Etreby, Mohamed Said El-Shorbagy, Al-Sayed Mohamed Rashed, Ahmed Mohamed Alsawy. (2021). Effect of High Volume Hemodiafiltration on Secondary Hyperparathyroidism Among Hemodialysis Patients. Science Journal of Clinical Medicine, 10(3), 78-84. https://doi.org/10.11648/j.sjcm.20211003.12

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ACS Style

Ezzat Abdalrahman El Etreby; Mohamed Said El-Shorbagy; Al-Sayed Mohamed Rashed; Ahmed Mohamed Alsawy. Effect of High Volume Hemodiafiltration on Secondary Hyperparathyroidism Among Hemodialysis Patients. Sci. J. Clin. Med. 2021, 10(3), 78-84. doi: 10.11648/j.sjcm.20211003.12

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AMA Style

Ezzat Abdalrahman El Etreby, Mohamed Said El-Shorbagy, Al-Sayed Mohamed Rashed, Ahmed Mohamed Alsawy. Effect of High Volume Hemodiafiltration on Secondary Hyperparathyroidism Among Hemodialysis Patients. Sci J Clin Med. 2021;10(3):78-84. doi: 10.11648/j.sjcm.20211003.12

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@article{10.11648/j.sjcm.20211003.12,
  author = {Ezzat Abdalrahman El Etreby and Mohamed Said El-Shorbagy and Al-Sayed Mohamed Rashed and Ahmed Mohamed Alsawy},
  title = {Effect of High Volume Hemodiafiltration on Secondary Hyperparathyroidism Among Hemodialysis Patients},
  journal = {Science Journal of Clinical Medicine},
  volume = {10},
  number = {3},
  pages = {78-84},
  doi = {10.11648/j.sjcm.20211003.12},
  url = {https://doi.org/10.11648/j.sjcm.20211003.12},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.sjcm.20211003.12},
  abstract = {Background: Despite increasing knowledge of the uraemic syndrome, both morbidity and mortality remain unacceptably high in patients with chronic kidney disease. Aim of the work: investigate the differences between conventional hemodialysis and hemodiafiltration in the context of chronic kidney disease metabolic bone disease findings serum calcium (sCa), phosphate (sPO4) and intact parathyroid hormone (PTHint) concentrations. Patients and methods: This prospective cross over study was approved by Almaadi hospital committee and included 95 patients with CKD5 on regular hemodialysis for at least 6 months. Patients were divided into two groups: Group A: 60 patients scheduled 6 months conventional high flux (hf-HD) (Period1) followed by 6 months of post-dilutional–HDF (Period2). Group B: (controls) included 35 patients were kept on conventional hf-HD for 12 months. (Period3) for 1st 6 months and (Period4) for 2nd 6 months. The main variables evaluated at the start as well as at the end of each period were sCa, sPO4 and PTHint. Results: There was highly significant statistical decrease in Phosphorus level in period2 compared to other groups after 2nd to 6th month and average of overall (pth month and average of overall (pnd to 6th month and average of overall (pst to 6th month and average of overall (pConclusion: The switch over from conventional Hf-HD to Ol-HDF results in a significant reduction of both PO4 and PTH concentrations, no significant changes in Ca concentrations.},
 year = {2021}
}

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TY  - JOUR
T1  - Effect of High Volume Hemodiafiltration on Secondary Hyperparathyroidism Among Hemodialysis Patients
AU  - Ezzat Abdalrahman El Etreby
AU  - Mohamed Said El-Shorbagy
AU  - Al-Sayed Mohamed Rashed
AU  - Ahmed Mohamed Alsawy
Y1  - 2021/10/28
PY  - 2021
N1  - https://doi.org/10.11648/j.sjcm.20211003.12
DO  - 10.11648/j.sjcm.20211003.12
T2  - Science Journal of Clinical Medicine
JF  - Science Journal of Clinical Medicine
JO  - Science Journal of Clinical Medicine
SP  - 78
EP  - 84
PB  - Science Publishing Group
SN  - 2327-2732
UR  - https://doi.org/10.11648/j.sjcm.20211003.12
AB  - Background: Despite increasing knowledge of the uraemic syndrome, both morbidity and mortality remain unacceptably high in patients with chronic kidney disease. Aim of the work: investigate the differences between conventional hemodialysis and hemodiafiltration in the context of chronic kidney disease metabolic bone disease findings serum calcium (sCa), phosphate (sPO4) and intact parathyroid hormone (PTHint) concentrations. Patients and methods: This prospective cross over study was approved by Almaadi hospital committee and included 95 patients with CKD5 on regular hemodialysis for at least 6 months. Patients were divided into two groups: Group A: 60 patients scheduled 6 months conventional high flux (hf-HD) (Period1) followed by 6 months of post-dilutional–HDF (Period2). Group B: (controls) included 35 patients were kept on conventional hf-HD for 12 months. (Period3) for 1st 6 months and (Period4) for 2nd 6 months. The main variables evaluated at the start as well as at the end of each period were sCa, sPO4 and PTHint. Results: There was highly significant statistical decrease in Phosphorus level in period2 compared to other groups after 2nd to 6th month and average of overall (pth month and average of overall (pnd to 6th month and average of overall (pst to 6th month and average of overall (pConclusion: The switch over from conventional Hf-HD to Ol-HDF results in a significant reduction of both PO4 and PTH concentrations, no significant changes in Ca concentrations.
VL  - 10
IS  - 3
ER  -

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