Background: Haemodiafiltration (HDF) has recently been shown to have a mortality benefit over conventional HD thought possibly due to better clearance of middle-sized molecules
such as FGF-23 (32 kDa) and β2-microglobulin (13 kDa). These are known to be highly elevated in chronic HD patients and some, such as FGF-23, may be biomarkers for cardiovascular risk. However, it is unclear what convection volume is required to achieve sufficient removal to be associated with a mortality benefit. Methods: Stable satellite HD patients (thrice-weekly dialysis, n = 19) were selected from 3 satellite dialysis centres. At 2-week intervals, patients were changed from low-volume HDF (15L), to conventional high-flux HD, to high-volume HDF (25L). Biochemical samples were taken before and after the Acalabrutinib concentration mid-week treatment of the second week. Middle- (β2-microglobulin) and small-molecule removal were compared as reduction ratios for each compound. Paired t-tests were performed for statistical analysis.
Results: β2-microglobulin concentrations fell more with HDF than with conventional HD. The reduction ratios were as follows: HD 66.44%, HDF15L 76.48%, HDF25L 82.05% (P < 0.0001). No significant changes were observed in clearance of the following small molecules: potassium, phosphate and urea. Conclusions: Consistent GDC-0973 clinical trial with previous reports, HDF with higher convection volumes produces the greatest fall in β2-microglobulin concentrations. This and other middle molecule removal may contribute to the mortality benefits offered by HDF compared with conventional HD. 244 ADIPOSE TISSUE AND INFLAMMATION STATUS ON HEMODIALYSIS
PATIENTS IN BANDUNG INDONESIA R SUPRIYADI1, J JONNY1, R SOELAEMAN1, RMA ROESLI1, AH MARTAKUSUMAH1, RS GONDODIPUTRO1, R BANDIARA1, M RUDIANSYAH2, H PRIBADI, M ISMELIA1, D ASTRID L1 1Division of Nephrology & Hypertension, Department of Internal Medicine, Faculty of Medicine, Amino acid Universitas Padjajaran/Hasan Sadikin Hospital Bandung; 2Division of Nephrology & Hypertension, Department of Internal Medicine, Faculty of Medicine, Universitas Lambung Mangkurat/Ulin Hospital Banjarmasin, Indonesia Aim: This study was conducted to describe the malnutrition and inflammation status on hemodialysis patients in Bandung, Indonesia. Background: Malnutrition and inflammation on hemodialysis (HD) patients are the most common conditions that could worsened and decrease the quality of life and increase morbidity and mortality of hemodialysis patients. Methods: Patients routinely on hemodialysis twice a week more than 3 months were recruited to the study.