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Titolo	Elevated Removal of Middle Molecules without Significant Albumin Loss with Mixed-Dilution Hemodiafiltration for Patients Unable to Provide Sufficient Blood Flow Rates
Autore	Jacky Potier a, Frank Le Roy b, Jean Paul Faucon c, Thibault Besselievre d, Eric Renaudineau e, Christian Farquet f, Pascale Soihan g, Dominique Touzard h, Asia Djema i, Toma Ilinca j- a Dialysis Unit, Centre Hospitalier, Cherbourg , b Dialysis Unit, Centre Hospitalier Universitaire, Rouen , c Dialysis Unit, Centre Hospitalier, Elbeuf , d Dialysis Unit, Centre Hospitalier, Alencon, e Dialysis Unit, Centre Hospitalier, Saint-Malo , f Dialysis Unit, ECHO, Cholet , g Dialysis Unit, Centre Hospitalier, Quimper , h Dialysis Unit, Centre Hospitalier, Laval , I Dialysis Unit, Centre Hospitalier, Cholet , and j Dialysis Unit, ECHO, Angers , France
Referenza	Blood Purif 2013; 36:78â83
Contenuto	Background: We examined the hypothesis that mixed-dilution online hemodiafiltration (MIXED) rather than predilution online hemodiafiltration (PRE) could enable patients with low blood flow rate (Qb) to benefit from advantages of convective therapies. Methods: Thirty-eight patients were included in a prospective, randomized, crossover and multicenter study conducted with a view to comparing the equilibrated Kt/V, reduction ratio (RR) of phosphates, β 2 –microglobulin (β 2 -M) and myoglobin (myo) between PRE and MIXED, each at two Q b values of 250 and 300 ml/min during 4 h sessions with a FX1000HDF dialyzer. Albumin losses (Alb) were also measured in 12 patients. Results: MIXED was always found to be more efficient compared to PRE notably for middle molecules (MM). RRβ2 -M: MIX250: 81.3 +/- 3.6 vs. PRE250: 75.2 Â+/- 5.9; MIX300: 82.7 +/- 3.6 vs. PRE300: 78.1 Â+/- 5.4; RRmyo: MIX250: 70.2 Â+/- 3.6 vs. PRE250: 42.6Â+/- 2.6; MIX300: 70.6 Â+/-3.6 vs. PRE300: 45.7 +/- 3.6 and with Alb Conclusion: MIXED allows patients unable to provide sufficiently high Q b to achieve high levels of MM removal.
Data	04.09.2013

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