HEMODIAFILTRATION: IMPACT ON PROTEIN- ENERGY WASTING AMONG DIALYSIS PATIENTS

Background and objectives: Hemodiafiltration (HDF) therapy is used in end stage renal disease (ESRD) patients under dialysis and combines the mechanisms of diffusion and convection, unlike conventional hemodialysis, based on diffusion transport. This therapy allows, among other things, an improvement in the hemodynamic stability, a lower resistance to the use of erythropoiesis stimulating agents (ESA) and a better clearance of inflammatory markers. There are no Latin American reports that assess nutritional parameters in this group of patients. Therefore we aimed to determine if HDF could have any impact on the protein-energy wasting characteristic of this population evaluated through biochemical and anthropometric nutritional variables. Methods: We performed a retrospective study with a total of 45 patients, comparing albumin, cholesterol, transferrin, hemoglobin, phosphorus, C-RP, erythropoietin resistance index (ERI) and dialysis dose (Kt/V) at the beginning of HDF treatment and six months later. 39 of these patients were also measured with high frequency bioimpedanciometry in order to determine the lean tissue index and the fat tissue index. Results: We analized data of 30 men and 15 women >18 years, with a mean age of 52.9 ± 18.22 years, and with a dialysis time of 57.6 ± 46.8 months. No statistically significant differences were found at baseline and six months after HDF treatment was started for the analyzed nutritional variables. Statistically significant differences were found for Kt/V and ERI (p