Effects of the Fluid Replacement Method During Online Hemodiafiltration on the Solute Removal Performance and Biocompatibility Using the Asymmetric Cellulose Triacetate Membrane.

INTRODUCTION

Pre-dilution online hemodiafiltration (Pre-HDF) is predominantly used in Japan, whereas post-dilution online HDF (Post-HDF) is more common in Europe. An asymmetric cellulose triacetate (ATA) membrane may improve biocompatibility. This study compared biocompatibility and solute removal performance between Pre- and Post-HDF using the ATA membrane.

METHODS

Eight stable maintenance hemodialysis patients underwent both Pre- (60 L/session) and Post-HDF (12 L/session) using an ATA membrane. Blood flow rate was 250 mL/min, total dialysate flow rate was 500 mL/min, and treatment time was 4 h. Biocompatibility and solute removal parameters were evaluated.

RESULTS

White blood cell and platelet counts showed mild decreases; inflammatory markers remained unchanged in both modalities. CD62P expression increased more in Post-HDF. Reduction rates of urea, creatinine, and α1-microglobulin were higher in Post-HDF, while β2-microglobulin was comparable. Albumin leakage was greater in Post-HDF.

CONCLUSIONS

Using the ATA membrane, Pre- and Post-HDF showed comparable biocompatibility, while Post-HDF provided superior solute removal performance.