Thrice-Weekly Nocturnal In-Centre Haemodiafiltration: A 2-Year Experience

• Main Authors: Vishal Dey, Mario Hair, Beng So, Elaine M. Spalding
• Format: Article
• Language: English
• Published: Karger Publishers 2015-08-01
• Series: Nephron Extra
• Subjects: Dialysis adequacy; Phosphate; Haemodialysis
• Online Access: http://www.karger.com/Article/FullText/436982

Background: Adequate control of plasma phosphate without phosphate binders is difficult to achieve on a thrice-weekly haemodialysis schedule. The use of quotidian nocturnal dialysis is effective but not practical in the in-centre setting. This quality improvement project was set up as an exercise allowing the evaluation of small-solute clearance by combining convection with extended-hour dialysis in a thrice-weekly hospital setting. Methods: A single-centred, prospective analysis of patients' electronic records was performed from August 2012 to July 2014. The duration of haemodiafiltration was increased from a median of 4.5 to 8 h. Dialysis adequacy, biochemical parameters and medications were reviewed on a monthly basis. A reduction in plasma phosphate was anticipated, so all phosphate binders were stopped. Results: Since inception, 14 patients have participated with over 2,000 sessions of dialysis. The pre-dialysis phosphate level fell from a mean of 1.52 ± 0.4 to 1.06 ± 0.1 mmol/l (p Conclusion: Phosphate control can be achieved without the need for binders or supplementation on a thrice-weekly in-centre haemodiafiltration program.