Thrice weekly nocturnal in-centre haemodiafiltration: a 2-year experience

Dey, V., Hair, M. and Spalding, E. M. (2015) Thrice weekly nocturnal in-centre haemodiafiltration: a 2-year experience. Nephron, 5, pp. 50-57. (doi: 10.1159/000436982) (PMID:26557842) (PMCID:PMC4592506)

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Background: Adequate control of plasma phosphate without phosphate binders is difficult to achieve on a thrice-weekly haemodialysis schedule. The use of quotidian nocturnal dialysis is effective but not practical in the in-centre setting. This quality improvement project was set up as an exercise allowing the evaluation of small-solute clearance by combining convection with extended-hour dialysis in a thrice-weekly hospital setting. Methods: A single-centred, prospective analysis of patients' electronic records was performed from August 2012 to July 2014. The duration of haemodiafiltration was increased from a median of 4.5 to 8 h. Dialysis adequacy, biochemical parameters and medications were reviewed on a monthly basis. A reduction in plasma phosphate was anticipated, so all phosphate binders were stopped. Results: Since inception, 14 patients have participated with over 2,000 sessions of dialysis. The pre-dialysis phosphate level fell from a mean of 1.52 ± 0.4 to 1.06 ± 0.1 mmol/l (p < 0.05). The average binder intake of 3.26 ± 2.6 tablets was eliminated. A normal plasma phosphate range has been maintained with increased dietary phosphate intake and no requirement for intradialytic phosphate supplementation. Conclusion: Phosphate control can be achieved without the need for binders or supplementation on a thrice-weekly in-centre haemodiafiltration program.

Item Type:Articles
Glasgow Author(s) Enlighten ID:Dey, Dr Vishal and Spalding, Dr Elaine
Authors: Dey, V., Hair, M., and Spalding, E. M.
College/School:College of Medical Veterinary and Life Sciences > School of Medicine, Dentistry & Nursing
Journal Name:Nephron
ISSN (Online):1423-0186
Copyright Holders:Copyright © 2015 The Authors
First Published:First published in Nephron 5:50-57
Publisher Policy:Reproduced under a Creative Commons License

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