Nephrology Dialysis Transplantation, Vol 13, Issue 90005 29-33, Copyright © 1998 by Oxford University Press
G Bonforte, M Surian, B Dozio, R Scanziani, A Baj, S Colombo and F Toffoletto
Large membrane pores and large quantities of reinfusion fluids can
influence the dialytic balance of trace elements in haemodiafiltration
(HDF). As there are no studies in HDF with on-line produced reinfusate, we
studied plasma or whole blood (*) concentrations of trace elements (Al,
Cd*, Cr* and Se: &mgr;/1; Cu, Pb* and Zn*: &mgr;/dl) of 24 on-line
HDF, 20 haemodialysis (HD) patients and 66-490 normal subjects (N). The
concentrations of Al (11.7±9.5), Cd (0.73±0.59) and
Cr (6.5±6.9) were significantly greater in on-line HDF patients
than in normal subjects (6±0.4; 0.6±0.2;
0.5±0.02), but similar to those of HD patients. In on-line HDF
patients, Cu (85.1±17.7), Pb (8±4.6), Se
(68±27) and Zn (546±103) concentrations were less
than in normal subjects (108±3.4; 11±0.8;
95±1.8; 673±23), and those of Cu and Zn were also
less than in HD patients (99.5±16.8; 670±65). At the
end of an on-line HDF treatment (42-69 studies), there was a significant
increase in Al (from 12.8±9.1 to 15.4±8.3), Cr (from
7.2±6.4 to 9.5±7), Cu (from 97.3±21.5 to
109.4± 27.2) and Zn (from 577±108 to
619±117). A longitudinal study (n = 16-18) for 12-30 months
documented stable concentrations of Al, Cd, Cr, Se and Zn and a significant
increase of Cu and Pb to normal concentrations. In conclusion, our on-line
HDF patients have elevated Al, Cd, Cr and decreased Cu, Pb, Se, Zn
concentrations in plasma or whole blood determinations. Cu and Pb normalize
with time; the other trace elements remain stable as documented by numerous
determinations. As the values for on-line HDF patients are similar to those
of HD patients, the level of accumulation or depletion of trace elements in
on-line HDF can be considered as safe as in HD; the increase in Al, Cd, Cu
and Zn at the end of treatment may be an expression of the increase of
those trace elements linked to proteins.Key words:
dialysis fluid; haemodialysis; on-line haemodiafiltration; trace
elements; uraemia
ORIGINAL ARTICLES
Plasma or whole blood concentrations of trace elements in patients treated by haemodiafiltration with on-line prepared substitution fluid
Servizio di Nefrologia e Dialisi e Medicina del Lavoro, Ospedale di Desio, Milano, Italy
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