Comparison of high-flux and low-flux hemodialysis filters on hemodialysis adequacy in under-hemodialysis patients with end-stage renal disease

Abstract Background: Hemodialysis is the most common alternative therapy in chronic renal failure and inadequate dialysis increases the mortality of patients; thus, the dialysis adequacy in these patients is important. This study aimed to compare the adequacy if hemodialysis high-flux and low-flux filters in Hospital Dialysis Centers of Shahrekord University of Medical Sciences, Iran, and assess its relation to other indices for patients with chronic and end-stage renal disease (ESRD). Methods: In a randomized clinical trial, 42 patients were performed with low-flux and high-flux filters. So, the patients with end-stage chronic kidney disease, with the rate of ultrafiltration of more than 3 liters, in the two cross groups underwent hemodialysis with high- and low-flux filters in 2 months. The indicators for measuring the Kt/V in each dialysis and other lab indices at the beginning and the end of each month were measured and compared using SPSS software. Findings: At the end of the intervention, significant difference in adequacy of dialysis was observed between the two groups of high- and low-flux filtration. Although, both groups of patients had adequacy of dialysis in terms of defined standards, but the findings showed that Kt/V in hemodialysis significantly was lower in high-flux group (P = 0.013). Conclusion: This study showed that the high-flux filters in higher volumes of 3 liters of ultrafiltration, increases the average dialysis adequacy more than the low-flux filters. We suggest future studies to assess the impact of long-term use of high-flux filters on dialysis efficacy, improved quality of life and reduced hospitalization rate in hemodialysis patients and its effect on reducing healthcare costs; patients are thereby cost-benefited in using high-flux filters for long term. Keywords: End-stage renal disease, Dialysis, Ultrafiltratio

Evaluation of the relationship between the reduction of serum uric acid level and control of blood pressure in patients with hypertension and hyperuricemia

Background: Hypertension is one of the most common diseases in the world causing mortality and morbidity; however it is not controlled well yet. Treatment of predisposing factors of hypertension can help to control this disease. Hyperuricemia is known as one of the risk factors of hypertension, but there are limited studies, whether reducing serum uric acid level can cause lowering high blood pressure or not. This study evaluated the effect of allopurinol -uric acid lowering drug- on uncontrolled hypertension in patients with hyperuricemia. Methods: This was a double-blind randomized clinical trial study on 50 patients with uncontrolled hypertension who also had hyperuricemia. After sex, age and body mass index (BMI) matching, the patients were divided to two groups: first group received 200 mg allopurinol daily and the second received placebo for two months. Systolic and diastolic blood pressure and serum uric acid level were measured at the start and end of study. Finally, the obtained data were analyzed using SPSS21 software. Findings: Allopurinol caused significant reduction in systolic (P = 0.0002) and diastolic (P = 0.0003) blood pressure. But, considering the age and sex, allopurinol is just significantly effective on lowering systolic and diastolic blood pressure in men older than 50 years, neither in men younger than 50 years nor in women. Conclusion: Treatment of hyperuricemia with allopurinol has positive effects on lowering blood pressure in men older than 50 years. It is not effective in men less than 50 years of age and in women. © 2015, Isfahan University of Medical Sciences(IUMS). All Rights Reserved. Evaluation of the relationship between the reduction of serum uric acid level and control of blood pressure in patients with hypertension and hyperuricemia. Available from: https://www.researchgate.net/publication/286862053_Evaluation_of_the_relationship_between_the_reduction_of_serum_uric_acid_level_and_control_of_blood_pressure_in_patients_with_hypertension_and_hyperuricemia [accessed Jul 26, 2017]