Clinical Study on Optimised Removal of Protein-bound Uremic Toxins With Convective Dialysis Treatment.

Clinical Study on Optimised Removal of Protein-bound Uremic Toxins With Convective Dialysis Treatment.

Clinical Study on Optimised Removal of Protein-bound Uremic Toxins With Convective Dialysis Treatment.

Patients will be treated with hemodiafiltration (HDF) in postdilution mode, as a control therapy, during 9 weeks. During week 5 the 1st intervention treatment, predilution hemofiltration (HF) or predilution HDF, will be performed as a midweek session. After 4 additional weeks of control therapy the other intervention treatment will be performed. Samples will be taken during week 4, 5 and 9: from inlet blood flow (0, 30, 60, 120 and 240 min), from outlet blood flow and dialysate outflow (30, 60, 120 and 240 min).

Performance of predilution hemofiltration, predilution hemodiafiltration or postdilution hemodiafiltration

Performance of predilution hemofiltration, predilution hemodiafiltration or postdilution hemodiafiltration is followed.

To evaluate what is more effective for convective removal of protein-bound solutes - predilution or postdilution of blood?

Samples taken at week 4, 5 and 9. Bloodsamples taken at 0, 30, 60, 120 and 240 min. Dialysate taken at 30, 60, 120 and 240 min.

To check which respective roles diffusion and convection play in the removal of protein-bound uremic toxins?

Samples taken at week 4, 5 and 9. Bloodsamples taken at 0, 30, 60, 120 and 240 min. Dialysate taken at 30, 60, 120 and 240 min.

Inclusion Criteria: stable on hemodialysis >= 6 months of which presently on high-flux HD >= 1 month 18 years < age < 85 years blood flow rate >= 300ml/min Exclusion Criteria: expected survival < 1 year expected transplant within < 1 year infectious diseases pregnancy chronic inflammation condition treated with single needle dialysis presently treated with hemodiafiltration or low-flux hemodiafiltration expected intradialytic body weight gain >= 4kg