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Nephrol Dial Transplant (2000) 15: 511-516
© 2000 European Renal Association-European Dialysis and Transplant Association

Intradialytic glucose infusion increases polysulphone membrane permeability and post-dilutional haemodiafiltration performances

Fabrice Vaussenat1, Bernard Canaud1, Jean-Yves Bosc1, Martine Leblanc2, Hélène Leray-Moragues1 and Laurie J. Garred3

1 Department of Nephrology, Lapeyronie University Hospital, Montpellier, France, 2 Department of Nephrology, Maisonneuve-Rosemont Hospital, Montréal, Québec and 3 Department of Chemical Engineering, Lakehead University, Thunder Bay, Ontario, Canada

Correspondence and offprint requests to: Prof. Bernard Canaud, Department of Nephrology, Lapeyronie University Hospital, F-34295 Montpellier, France.

Introduction. During real-time monitoring of the ultrafiltration coefficient (Kuf) in haemodiafiltration (HDF), it was noticed that the ultrafiltration performance of polysulphone membrane dialysers increased when hypertonic glucose (D50%) was administered through the venous blood return.

Methods. This observation was explored in six non-diabetic chronic dialysis patients during 48 HDF sessions using 1.8 m2 polysulphone membrane dialysers. In all six patients, 24 sessions were performed with glucose supplementation (as a continuous D50% (500 g/l) infusion at 40 ml/h) and 24 sessions without supplementation.

Results. Glucose supplementation led to a marked increase in Kuf from 22.8±2.2 (without D50%, n=24) to 32.1±3.9 ml/h/mmHg (with D50%, n=24) (P<0.0001). An increase in percentage reduction ratios for urea and creatinine were also consistently observed during the sessions with glucose administration (from respective mean values of 75±5 and 68±4% to 79±4 and 74±10%). Mean double-pool Kt/V, calculated from serum urea concentrations, rose from 1.65±0.24 (n=24) to 1.86±0.24 (n=24) (P<0.005). Similar results were observed in a subgroup of 18 HDF sessions (nine with glucose and nine without) monitored with an on-line urea sensor of spent dialysate. No detrimental effects were induced at any time.

Conclusions. We conclude that intravenous glucose administration during high-flux HDF using polysulphone membranes increases significantly both ultrafiltration capacity and dialysis dose delivery.

Keywords: haemodiafiltration performances; glucose dialysis dose; membrane permeability


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