FP545
EFFECTIVENESS OF INTERMITTENT INFUSION HEMODIAFILTRATION (I-HDF) USING ULTRAPURE DIALYSIS FLUID Free

Introduction and Aims: In a typical hemodialysis (HD) treatment, excessive water removal often induces hypotension and muscle spasm. Intermittent infusion hemodiafiltration (I-HDF) using backfiltration of an ultrapure dialysis fluid by an automated dialysis machine, GC-110N (JMS Co. Ltd., Tokyo, Japan), has been developed to improve the peripheral circulation of the patient by repeated intermittent infusion during a traditional HD treatment. Under a typical I-HDF treatment, some 200-300 mL of ultrapure dialysis fluid was infused into the blood component through the dialysis membrane at a rate of 100 mL/min, every 30 min. I-HDF, namely, means a modified HDF system with replacement fluid of only 1.4 to 2.1 L(= 200-300 mL x 7 times)/session.

Methods: In this paper, twenty chronic renal disease patients participated in a multi-center clinical trial to evaluate the clinical effectiveness of I-HDF compared with conventional HD (CHD).

Results: Increasing peripheral blood flow rate in the patient’s toe was detected by a laser flowmeter for each infusion in many patients. A significantly lower value for time-averaged BV reduction was obtained with I-HDF compared with CHD in spite of there being no difference in the total amount of water removal. The amount of normalized solute removal, cleared space (CS), for inorganic phosphate and α 1-MG during a treatment were higher with I-HDF than CHD. Moderate α 1-MG K reduction was found in I-HDF due to the prevention of membrane fouling by intermittent backfiltration of the dialysis fluid.

Conclusions: Intermittent Infusion HDF using an automated dialysis machine was effective for improvement of the peripheral circulation of dialysis patients.