Benefits of the nephros dual stage ultra-filter in chronic hemodialysis patients: Evidence for improved ESA responsiveness

11^th International Conference on Nephrology & Urology

March 22-23, 2017 Rome, Italy

Ronald Villota

New York Presbyterian Hospital-Columbia University Medical Center, USA

Scientific Tracks Abstracts: J Nephrol Ther

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.

Biography :

Email: rov9014@nyp.org