Abstract
Background: Despite increasing knowledge of the uraemic syndrome, both morbidity and mortality remain unacceptably high in patients with chronic kidney disease. Aim of the work: investigate the differences between conventional hemodialysis and hemodiafiltration in the context of chronic kidney disease metabolic bone disease findings[serum calcium (sCa),phosphate(sPO4) and intact parathyroid hormone (PT Hint)concentrations. Patients and methods: This prospective cross over study was approved by Almaadi hospital committee and included 95patients with CKD5 on regular hemodialysis for at least 6months.Patients were divided into two groups: Group A:60patients scheduled 6months conventional high flux (hf- HD)(Period1)followed by 6months of post-dilutional–HDF(Period2).Group B:(controls)included 35patients were kept on conventional hf-HD for12months.(Period3)for 1st 6months and(Period4) for 2nd 6months.The main variables evaluated at the start as well as at the end of each period were sCa,sPO4 and PT Hint. Results: There was highly significant statistical decrease in Phosphorus level in period2 compared to other groups after 2nd to 6th month and average of overall(p<0.001).A significant statistical decrease was found in Parathormone level and CRP in period2 compared to other groups after 1month to 6th month and average of overall(p<0.05).There was significant statistical decrease in Albumin level in period2 compared to other groups after 2nd to 6th month and average of overall(p<0.05).There was a significant statistical increase in kt/v in period2 compared
to other groups after 1st to 6th month and average of overall (p<0.05).Conclusion: The switch over from conventional Hf-HD to Ol-HDF results in a significant reduction of both PO4 and PTH concentrations, no significant changes in Ca concentrations.
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