Influence of the dialysis membrane type on quality of life, clinical outcomes and laboratory parameters in patients undergoing hemodialysis

Abstract

Background. High-flux haemodialysis uses dialysis membranes of significant porosity for larger molecules (ß2- microglobulin clirens >20 ml/min ) and allows coefficient of ultrafiltration  ( CUF >l5ml/mmHg per hour). Preliminary results pointed that anaemia was more easily corrected in patients on high-flux membranes, while randomized trials failed to prove significant effect. Total blood triglycerides, VLDL triglycerides and VLDL cholesterol decreased, and HDL increased in polysulphone  high-flux group, while these variables remained unchanged in group of patients on standard dialysers.

Objective: Comparison has been made between patients on high-flux hemodialysis and low-flux hemodialysis in regard to quality of life,  clinical outcome and laboratory results.

Methods : The study was investigator-driven, cross-sectional, and based on the intention-to-treat principle. The study population was composed of patients  on dialysis treatment (18 to 70 years of age ) in regional health centre „ Studenica “ , Kraljevo.

The patients belonged to low-flux hemodialysis ( n=33 ) or  high-flux hemodialysis ( n=39 ). The patients were interviewed  from December 2009  until January 2010. Results of laboratory tests and data on comorbidities  were obtained from  medical records . Informations about quality of life and habits were obtained from Comprehensive Quality of Life Scale – Adult “. 

Results.

Serum levels of urea were significantly different between patients on high-flux dialysers and those on low –flux dialyzers (t= 1.996, p= 0.052 ). For other laboratory parameters, clinical symptoms, comorbidities, habits, and quality of life - no significant differences were found.

Conclusion: Although  high porosity high-flux haemodialysis membranes remove waste solutes more efficiently than low flux membranes with smaller pores, this fact did not translate to significant differences in quality of life of the patients..

Key Words. Dialyzers, quality of life, laboratory analysis