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Titolo:
A prospective randomised European multicentre study of medium-long run mortality and morbidity comparing acetate-free biofiltration and bicarbonate dialysis
Autore:
Santoro, A; Panzetta, G; Tessitore, N; Atti, M; Mancini, E; Esteban, J; London, G; Ara, JM; Miguel, JL; Neumann, KH; Opatrny, K; Perez, R; Perrone, B; Wizemann, V; Zucchelli, P;
Indirizzi:
S Orsola M Malpighi Hosp, Policlin S Orsola Malpighi, Malpighi Nephrol & Dialysis Div, I-40138 Bologna, Italy S Orsola M Malpighi Hosp Bologna Italy I-40138 v, I-40138 Bologna, Italy
Titolo Testata:
JOURNAL OF NEPHROLOGY
fascicolo: 6, volume: 12, anno: 1999,
pagine: 375 - 382
SICI:
1121-8428(199911/12)12:6<375:APREMS>2.0.ZU;2-M
Fonte:
ISI
Lingua:
ENG
Soggetto:
NITRIC-OXIDE; HEMODIALYSIS; HEMODIAFILTRATION; THERAPY;
Keywords:
dialysis modalities; cardiovascular instability; treatment tolerance; quality of life;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Citazioni:
33
Recensione:
Indirizzi per estratti:
Indirizzo: Santoro, A S Orsola M Malpighi Hosp, Policlin S Orsola Malpighi, Malpighi Nephrol & Dialysis Div, Via P Palagi 9, I-40138 Bologna, Italy S Orsola M Malpighi Hosp Via P Palagi 9 Bologna Italy I-40138
Citazione:
A. Santoro et al., "A prospective randomised European multicentre study of medium-long run mortality and morbidity comparing acetate-free biofiltration and bicarbonate dialysis", J NEPHROL, 12(6), 1999, pp. 375-382

Abstract

In recent years, the progressive increase in the mean age of the population entering chronic dialysis treatment has been responsible, on the one hand, for the growing number of patients undergoing regular dialysis, and on the other, for the high number of "critical" patients, both as a result of their age and the presence of concomitant morbidity. Thus, dialysis treatmenttoday is not only aimed at waste removal and waterelectrolyte homeostasis,but also at a reduction in morbidity and mortality, and at improving the patients' quality of life, thanks to the use of biocompatible materials and the achievement of good cardiovascular tolerance to treatment. Consequently, diffusive-convective dialysis procedures have been on the increase, sincethey combine better depuration with the use of biocompatible high-flux membranes. Acetate-free biofiltration (AFB) is a diffusive-convective dialysisprocedure which utilises a high-flux membrane, AN69, post-dilution infusion of a sodium bicarbonate solution (NaHCO3), and a dialysate which is completely free of any buffer, and thus also free of acetate, which may have various negative effects on the patient. A number of studies have already shown the better hemodynamic stability and the reduction of intradialytic side-effects during AFB. All these, however, were short-term studies. To verify the beneficial effects of AFB in the long run, a three year multicentre randomised European trial has been proposed to compare bicarbonate hemodialysis (BD), a technique used in nearly 80% of the world's dialysis population, and AFB. The specific aim of the investigation is to verify, in a large number of patients, the results of hemodialysis treatment iu terms of morbidity; mortality and quality of life. The study involves 80 hemodialysis units across Italy, France, Germany, Spain, Slovenia and Croatia, with enrolment of about 400 patients considered "critical" for at least one of the following reasons: age, diabetes, dialysis cardiovascular instability. Fifty percent of the patients are to undergoAFB with the AN69 membrane and bicarbonate solution infusion (NaHCO3 145 or 167 mEq/lt), and the other fifty percent are to be treated by BD, with any membrane except the non-modified cellulosic one. Biochemical, cardiological, and nutritional parameters will be considered throughout the study. Mortality, morbidity both in terms of intra- and interdialysis symptoms - and hospitalisation rate, as well as the patients' quality of life, evaluated by the SF36 questionnaire, will be analysed.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 04/12/20 alle ore 01:20:04