Mid-dilution hemodiafiltration: a comparison with pre- and postdilution modes using the same polyphenylene membrane.

As a change from Diapes to polyphenylene membrane in the mid-dilution filter has recently been developed, the aim of this study was to compare mid-dilution using this new dialyzer versus pre- and postdilution. The prospective study included 20 patients who underwent 4 hemodiafiltration (HDF) sessions: 1.7 m(2) polyphenylene and predilution infusion flow (Qi) 200 ml/min, 1.7 m(2) and postdilution Qi 100 ml/min, 1.9 and 2.2 m(2) mid-dilution both with Qi 200 ml/ min. The urea and creatinine reduction ratios were slightly higher in postdilution. The beta(2)-microglobulin (85.8%), myoglobin (73.6%), prolactin (67.8%) and retinol-binding protein (29.2%) reduction ratios with 1.9 m(2) mid-dilution, which was similar to 2.2 m(2) mid-dilution, were significantly higher than with the post- and predilution modes. Mid-dilution appears to be a good HDF alternative that allows a better removal of larger molecules than postdilution and, mainly, predilution. Mid-dilution using 1.9 or 2.2 m(2) dialyzers, at the same convective volume, showed a similar removal. Copyright 2009 S. Karger AG, Basel.