Effect of the high-flux hemodialysis on cardiovaskular and endothelial function

II. ABSTRACTEffect of the High-Flux Hemodialysis on Cardiovascular and Endothelial FunctionIntroduction: Although there have been important improvements in the treatmentof Chronic Renal Insufficiency (CRI), the survival rate is still too low. Extendedhaemodialysis is superior to the conventional dialysis in terms of anemia andhypertension control and high survival rate but it has some disadvantages such as highcost and requiring long time, which is not desired by the patients.The effects of short High-flux dialysis on cardiovascular system and endothelialfunctions must be discussed. The effects of High-flux dialysis on Cardiovascular diseaseand endothelial functions have been examined in the haemodialysis patients to whomIntensive Extra Cellular Volume control had been performed.Methods: 52 (CRI) patients have been randomised to High-flux (2.5-hoursessions, three times a week) and Low-flux (4-hour sessions, three times a week) dialysisgroups and have been observed clinically in a 52-week term.Results: The results in High-flux and Low-flux groups were respectively asfollows; urea Kt/V 1.45±0.3 and 1.60±0.3, interdialytic weight increase 1.5±0.5 and1.9±0.6 kg, pre-dialysis systolic BP 107±14 and 115±17 mmHg, diastolic BP 66±8 and70±10 mmHg, intradialytic hypotension attack %2.1±3 and %4.0±3, left ventricular massindex 104±26 and 106±26 g/m2, Ejection fraction %60±9 and %64±8, homosistein8.4±3.7 and 12.0±11 umol/L, D-dimer 206±143 and 238±154 mg/L, vonWillebrandfactor %146±66 and %154±57, CRP 3.8±1.4 and 4.5±2.1 mg/L, Haemoglobin 11±1.3and 11±1.4 g/dl, Albumin 4.1±0.4 and 4.0±0.3 g/dl, Calcium 10±0.8 and 9±0.8 mg/dl,Phosphor 5.4±1.8 and 6.0±1.3 mg/dl, Parathormon 213±144 and 226±111 pg/ml. Therewere not any remarkable statistical differences between the results.It has been determined that short High-flux dialysis does not damagecardiovascular structure and functions and it cleans tocsins with small and mediummolecules even more effectively. And also some favourable effects have beendetermined such as; decrease in erythropoietin resistance and effective removal ofmicroinflammatory tocsins those have part in atherosclerosis pathogenesis.Conclusions: High-flux dialysis is expected to be the conventional dialysis in the futurebecause of being safe, making sufficient and even superior dialysis in a short time, andbeing attractive for patients, dialysis centres and health assurance institutions.Key words: Hemodialysis, Cardiovascular disease, High-flux dialysis