The Effectiveness of On-Line Hemodiafiltration on beta-2 Microglobulin Clearance in End Stage Renal Disease
Anchana Panich MD*, Khajohn Tiranathanagul MD**, Kearkiat Praditpornsilpa MD**, Somchai Eiam-Ong MD**
Affiliation : * Department of Medicine, Pra Chom Klao Hospital, Petchaburi ** Division of Nephrology, Department of Medicine, Faculty of Medicine, Chulalongkorn University Hospital
Objective : To compare β2-microglobulin (β2M) clearance between on-line hemodiafiltration (HDF) and high
flux demodialysis (HFHD).
Materials and Methods : The total, convection/diffusion, and membrane adsorption components of β2M clearance
in 10 hemodialysis patients treated with on-line HDF, at the replacement fluid rates of 75 (HDF75) and 125
(HDF125) mL/min, were determined and compared with HFHD.
Results : The total β2M clearance in the HDF 125 group was significantly higher than the HDF75 group
(124.5 + 4.4 vs 101.3+4.1 mL/min; p < 0.05); both values were much greater than the HFHD group (p < 0.01).
The convection/diffusion was the major portion of total β2M clearance in all three groups. The values of
convection/diffusion and membrane adsorption in both HDF groups were about 2 and 3 times, respectively, of
the HFHD group (p < 0.01). Both components of β2M clearance in the HDF125 group did not statistically
differ from the HDF75 group, however; the value of convection/diffusion clearance in HDF125 was more than
in the HDF75 group. Regarding Kt/Vurea and phosphate clearance, there were no significant differences
among the study groups.
Conclusion : On-line HDF could provide more β2M clearance than HFHD by increasing both the convection/
diffusion, and membrane adsorption clearances. HDF125 provided more total β2M clearance than HDF75
from the convection/diffusion mechanism while the adsorptive mechanisms were equal.
Keywords : Hemodiafiltration, High flux hemodialysis, β2-microglobulin, Convection/diffusion, Membrane adsorption
