alexa Benefits Of The Nephros Dual Stage Ultra-filter In Chronic Hemodialysis Patients: Evidence For Improved ESA Responsiveness
ISSN: 2161-0959

Journal of Nephrology & Therapeutics
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11th International Conference on Nephrology & Urology
March 22-23, 2017 Rome, Italy

Ronald Villota
New York Presbyterian Hospital-Columbia University Medical Center, USA
ScientificTracks Abstracts: J Nephrol Ther
DOI: 10.4172/2161-0959.C1.036
Abstract
Ultrapure dialysate has been shown to reduce inflammatory markers and improve nutritional and anemia parameters in patients on chronic maintenance hemodialysis. The DSU (dual stage ultra-filter) has been shown to reduce bacterial counts and endotoxin levels by at least a 5-log order of magnitude. We performed an observational trial of this filter in a hospital-based acute dialysis facility in the USA. There were 23 chronic stable hemodialysis outpatients at New York Presbyterian Hospital–Columbia University Medical Center treated during the six months after the installation of the DSU filters. The mean age was 51 (range 12-91), 61% male, predominantly hispanic (70% hispanic, 17% African-American, 9% Caucasian and 4% Asian) and 30% diabetic. Comparing data from the six months period after the installation of the filters to the preceding six months, there was an increase in the mean hemoglobin level of 0.5 g/dL (p=0.010) with a reduction in the mean weekly darbepoetin dose of 14.6 mcg (P<0.001) translating to a reduction in the ESA resistance index (weekly ESA dose/hemoglobin level) of 1.52 (p<0.001). During this time period, indirect inflammatory markers showed a reduction in the mean WBC count of 0.46 (p=0.008), an increase in serum albumin of 0.08 (p=0.024), an increase in the TSAT of 1.0% (p=0.34, NS) and an increase in the serum ferritin of 85 (p=0.06). In conclusion, the use of a filter to further reduce endotoxin exposure in chronic hemodialysis patients can result in improved ESA responsiveness and a lower ESA dose.
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