FP463ALBUMIN/C-REACTIVE PROTEIN RATIO IN THE TREATMENT OF PATIENTS WITH CHRONIC KIDNEY DISEASE - HIGH FLUX HEMODIALYSIS VS. ONLINE HEMODIAFILTRATION

Abstract

Introduction and Aims: Recent data showed that online hemodiafiltration (olHDF) was more advantageous than high-flux hemodialysis (HD) with regard to a greater clearance of middle molecules and an improved inflammatory status of dialysis patients, while there were different results for mortality outcomes. The aim of this pro-spective, multicentric, crossover study was to analyze the influence of olHDF and HD on inflammatory and nutritive parameters in dialysis patients. Methods: After a three-month washout phase with HD (dialyzer FX80) a total of 62 patients were treated for nine months with olHDF (dialyzer FX800) followed by nine months with HD (dialyzer FX80) or vice versa. The primary end point of this study was the albumin/C-reactive protein ratio. Results: There was no difference in the patients'mean albumin/C-reactive protein ratios comparing HD vs. olHDF treatments. Significantly lower albumin and pre-albu-min levels and a higher amount of albumin in the dialysate were recorded in patients treated with olHDF. There were no significant differences in C-reactive protein levels. After treatment with olHDF patients showed a higher removal of beta-2-microglobulin. There were no significant changes between HD and olHDF treatments regarding proin-flammatory cytokine levels in the plasma, the cardiovascular status (ejection fraction, left ventricular mass index), antihypertensive treatment, reduction of phosphate binder doses, erythropoiesis-stimulating agent doses and hemoglobin variability. Conclusions: In this study, HD and olHDF had the same impact on inflammatory and nutritive parameters, while the removal of beta-2-microglobulin and losses of albumin were higher in the olHDF group.