scholarly journals The Dose per Fraction May be correlated with Late Kidney Toxicity after Total Body Irradiation: a Single Institution Experience

2019 ◽  
Vol 2 (1) ◽  
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Total Body Irradiation ◽  
Group A ◽  
The Common ◽  
Total Body ◽  
Group B ◽  
Chronic Kidney Disease Group ◽  
Dose Per Fraction

Background: The purpose of the present study was to retrospectively evaluate the subacute or late toxicities in the kidney, lung, and liver after two total body irradiation regimens, 12 Gy in 6 fractions (group A) and 12 Gy in 4 fractions (group B). Methods: Forty-two patients who underwent total body irradiation (group A, n=32; group B, n=10) between June 1997 and June 2013 were included in the present study. The median follow up period was 60 months (range: 3–219 months) for the patients in group A and 143 months (range: 5–220 months) for the patients in group B. We evaluated the renal, pulmonary, and hepatic toxicities using the Common Terminology Criteria for Adverse Events version 4.0. Results: There were 4 cases of chronic kidney disease (group A, n=1; group B, n=3). Although the cumulative incidence of chronic kidney disease differed significantly between the two total body irradiation regimens (p=0.014), the pulmonary and hepatic toxicities did not differ to a statistically significant extent. Conclusion: The present study suggests that a higher dose per fraction caused a higher incidence of chronic kidney disease.

MO777HISTOLOGICAL AND IMMUNOPHENOTYPICAL VESSEL CHANGES IN CHRONIC KIDNEY DISEASE

2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
Aikaterini Lysitska ◽  
Nikiforos Galanis ◽  
Ioannis Skandalos ◽  
Eustathios Mitsopoulos ◽  
Nikolaos Antoniadis ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Internal Carotid ◽  
Intima Media Thickness ◽  
Carotid Intima Media Thickness ◽  
Atherosclerotic Lesions ◽  
Ckd Stage ◽  
Group A ◽  
The Common ◽  
Group B

Abstract Background and Aims Recent studies suggest thw possibility of activating immune mechanism in the onset and progression of atherosclerotic disease. The aim of the present study was to evaluate the role of immune mechanisms in the vessel of patients with Chronic Kidney Disease (CKD) and the association with clinical and laboratory indicators of atherosclerosis. Method Patients with CKD stage V, in whom a radiocephalic arteriovenous fistula (RC-AVF) was created, were included in the study. Patients were divided in two groups, group A was consisted of patients who were on stage V, pre-dialysis, and being prepared to start on hemodialysis (HD), and those who had already been on HD for at least 3 years, and were having a new RC-AVF formation, due to previous failure, group B. Inclusion criteria were: age 25-80 years, gradual deterioration of renal function up to stage V or under dialysis for more than 3 years. All patients should have been under close follow up for at least 3 years prior to enrolment, with adequate control of diabetes, hypertension, dyslipidemia, secondary hyperparathyroidism and anemia. The control group included healthy volunteers of similar age, sex and ethnicity, who agreed to have a radial artery biopsy during an orthopedic procedure because of a fracture. All patients were informed and signed the consent form. Patients’ history, primary disease and comorbid conditions, medication and clinical examination were recorded based on hospital outpatients’ files. Prior to the scheduled day of RC-AVF creation, all patients underwent laboratory examination, included hematological and serum biochemical analyses. The histological characteristics, inflammatory activation and immunophenotypic alterations of the radial artery wall were estimated and their association with the severity of calcification and atherosclerosis were studied. Presence and severity of atherosclerotic lesions in CKD patients was assessed based on the measurement of common carotid intima – media thickness (IMT) of the common and internal carotid on both sides. Results Significant correlation was fount between inflammatory infiltration [expression of CD3(+), CD20(+), CD68(+) cells], cellular activation [CD34(+), a-SMA(+) cells] and calcification regulators (MPG, RANKL, OPG) with the degree of vascular calcification, as this was estimated and classified based on Verhoff’s Elastic and von Kossa staining Forty five patients with chronic kidney disease (CKD), stage V, either pre-dialysis (p=25) (group A) or on hemodialysis (HD) (p=20) (group B) were included in the study. There were no significant differences in age, sex, race, and also in the frequency of hypertension, diabetes mellitus or smoking habits between patients and controls. Presence and severity of atherosclerotic lesions in CKD patients was assessed based on the measurement of common carotid intima – media thickness (IMT) of the common and internal carotid on both sides. Conclusion Atherosclerotic disease in Chronic KidnEy Disease and its clinical effects appear to be directly related to inflammatory ifiltration of blood vessels by T, B lymphocytes, macrophages and myofibrolasts, as well as factors that affect calcification.

scholarly journals P748 Three-year echocardiographic outcomes in MitraClip patients with chronic kidney disease

2020 ◽  
Vol 21 (Supplement_1) ◽  
Author(s):  
A Tavernese ◽  
V Cammalleri ◽  
A Sanseviero ◽  
P De Vico ◽  
S Muscoli ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Left Ventricular ◽  
Left Ventricular Ejection ◽  
Systemic Hypertension ◽  
Systolic Pulmonary Artery Pressure ◽  
Kaplan Meier ◽  
Group A ◽  
Group B

Abstract Background Chronic kidney disease (CKD) has been shown to impact negatively the prognosis of patients with heart failure, coronary artery or valvular heart disease and emerged as predictor of poor outcomes in mitraclip population. Purpose Aim of our study was to evaluate three-year echocardiographic outcomes in CKD patients with severe mitral regurgitation (MR) treated with mitraclip. Methods This in an observational study including patients treated with mitraclip in our institution, who completed three years of follow up. Patients population was divided into two groups according to basal creatinine clearance (CrCl): group A, including patients with normal/mild decline of renal function (CrCl > 60 ml/min) and group B, including patients with CKD (CrCl < 60 ml/min). Demographic and procedural characteristics were compared, as well as echocardiographic data, including grade of MR, left ventricular ejection fraction (LVEF), mean transmitral gradient and systolic pulmonary artery pressure (sPAP). Kaplan-Meier survival curves were obtained. Results The study population consists of 107 patients (mean age 71 ± 9 years, 69% male): 57 belonging to group A and 50 to group B. Patients of group B had higher values of LogEuroScore (22 ± 10 vs.15 ± 9 p = 0,0002), systemic hypertension (92% vs. 74%, p = 0,026), complicated diabetes (46% vs. 24% p = 0,034) and NYHA IV before the procedure (24% vs 9 %, p = 0,059). Additionally, patients of group B had lower baseline LVEF (35 ± 11 vs. 41 ± 13; p = 0,012). Procedural success was similar between the two groups without significant difference in degree of MR reduction after mitraclip implantation. Echocardiographic follow-up showed that in group B, the LVEF did not improve after the treatment (more than 50% had LVEF < 35% at 1,2 and 3 years) while in the group A it improved significantly (LVEF < 35% from 47,6% at discharge to 29%, 32% and 31% at 1, 2 and 3 years, respectively). In comparison to group A, in group B a progressive increase in residual MR grade was observed (moderate-to-severe MR from 2% at discharge to 14%, 15%, and 27% at 1, 2 and 3 years, respectively) as well as in the mean transmitral gradient (from 3,90 ±1,6 mmHg after the mitraclip implantation to 5,28 ± 1,7; 5,73 ± 1,75; 6,06 ±1,75 at 1, 2 and 3 years, respectively) and sPAP (from 47 ± 12 mmHg at discharge to 49 ± 21; 51 ± 20; 48 ± 22 at 1, 2 and 3 years, respectively). Kaplan Meier estimate of survival free from in-hospital readmission was 77% in group A and 61% in group B (Log-Rank 4.563, p = 0,033) and survival free from cardiovascular death was 95% and 81,5%, in group A and B, respectively (Log-Rank 4.806, p = 0,028). Conclusion Our results suggest that CKD patients have poorer outcomes after mitraclip implantation with worsening of some echocardiographic parameters, particularly for residual MR degree, mean transmitral gradient and sPAP, without improvement in LVEF at one, two and three years of follow-up.

Acute coronary syndromes in chronic kidney disease patients: the good, the bad or the ugly?

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
C Saleiro ◽  
D De Campos ◽  
J Lopes ◽  
R Teixeira ◽  
J.P Sousa ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Systolic Function ◽  
Lv Function ◽  
Angiotensin Ii Antagonist ◽  
All Cause Mortality ◽  
Group A ◽  
Lv Ejection Fraction ◽  
Group B ◽  
Lv Systolic Function

Abstract Background Patients with chronic kidney disease (CKD) are at increased risk of composite cardiovascular (CV) events and all-cause mortality. However, current aggressiveness of therapeutic strategies may minimize the course of the disease. Aim To assess the prognostic impact of optimized medical treatment in a CKD population with acute coronary syndrome (ACS). Methods 355 ACS patients admitted to a single coronary care with CKD who were discharged from hospital were included. Those with end-stage renal disease were excluded. Three groups were created based on the KDIGO classification: Group A (Stage 3A, eGFR [estimated glomerular filtration rate] 45–59mL/min/1.73 m2) N=190; Group B (Stage 3B, eGFR 30–44mL/min/1.73 m2) N=113; and Group C (Stage 3B, eGFR 15–29mL/min/1.73 m2) N=52. The primary endpoint was long-term all-cause mortality. Kaplan-Meyer survival curves and Cox regression were done. The median of follow-up was 32 (IQ 15–70) months. Results Groups were similar regarding demographics, CV risk factors, ACS type, heart failure diagnosis, left ventricular (LV) systolic function, peak troponin, multivessel disease, treatment option (PCI, CABG or OMT) and medical therapy at discharge. More advance renal failure patients had a higher prevalence of diabetes mellitus (DM), a lower haemoglobin, a higher NT-proBNP and were less likely to receive ACE inhibitors/angiotensin II antagonist at discharge. 170 patients met the primary outcome. Kaplan-Meyer curves showed decreased survival with worse renal function (Group A 68% vs Group B 57% vs Group C 37%, Log Rank P=0.006 – Figure 1). After adjustment for age, DM, haemoglobin, NT-proBNP, LV systolic function and ACE inhibitors/angiotensin II antagonist at discharge, eGFR was not associated with increased death (HR 1.00, 95% CI 0.98–1.01). In this model, only age (HR 1.04, 95% CI 1.01–1.07), haemoglobin (HR 0.86, 95% CI 0.979–0.94), Nt-proBNP (HR 1.00, 95% CI 1.00–1.00) and impaired LV function (LV ejection fraction 40–49%: HR 2.95, 95% CI 1.89–4.81; LV ejection fraction <40%: HR 2.15, 95% CI 1.44–3.21) remained associated with the outcome. Conclusion The worse outcome attributed to CKD after an ACS seems to be related not the eGFR itself but to associated comorbidities such as age, anaemia, fluid overload and impaired LV function. The fact that some of these comorbidities may be altered by intensive therapy indicates that CKD patients should also be candidates to optimized medical treatment. Funding Acknowledgement Type of funding source: None

scholarly journals Effect of Dietary Supplements in Reducing Probability of Death for Uremic Crises in Dogs Affected by Chronic Kidney Disease (Masked RCCT)

2012 ◽  
Vol 2012 ◽  
pp. 1-7 ◽  
Author(s):  
Andrea Zatelli ◽  
Marco Pierantozzi ◽  
Paola D'Ippolito ◽  
Mauro Bigliati ◽  
Eric Zini
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Mortality Rate ◽  
Dietary Supplements ◽  
Dietary Supplementation ◽  
Phosphate Binders ◽  
Group A ◽  
Probability Of Death ◽  
Group B ◽  
To Receive

Chitosan and alkalinizing agents can decrease morbidity and mortality in humans with chronic kidney disease (CKD). Whether this holds true in dog is not known. Objective of the study was to determine whether a commercial dietary supplement containing chitosan, phosphate binders, and alkalinizing agents (Renal), compared to placebo, reduces mortality rate due to uremic crises in dogs with spontaneous CKD, fed a renal diet (RD). A masked RCCT was performed including 31 azotemic dogs with spontaneous CKD. Dogs enrolled in the study were randomly allocated to receive RD plus placebo (group A; 15 dogs) or RD plus Renal (group B; 16 dogs). During a first 4-week period, all dogs were fed an RD and then randomized and clinically evaluated up to 44 weeks. The effects of dietary supplements on mortality rate due to uremic crises were assessed. At 44 weeks, compared to group A, dogs in group B had approximately 50% lower mortality rate due to uremic crises (P=0.015). Dietary supplementation with chitosan, phosphate binders, and alkalinizing agents, along with an RD, is beneficial in reducing mortality rate in dogs with spontaneous CKD.

scholarly journals A comparison between Chinese finger trap and Roman sandals suturein peritoneal dialysis catheters for chronic kidney disease appliedin veterinary medicine

2020 ◽  
Vol 71 (01) ◽  
pp. 8-11
Author(s):  
BOGDAN ALEXANDRU VIȚĂLARU ◽  
MĂDĂLIN ION RUSU ◽  
CARMEN MIHAI ◽  
ALEXANDRU CHIOTOROIU
Keyword(s):  
Chronic Kidney Disease ◽  
Peritoneal Dialysis ◽  
Kidney Disease ◽  
Chronic Treatment ◽  
Chronic Peritoneal Dialysis ◽  
Peritoneal Catheter ◽  
Catheter Migration ◽  
Group A ◽  
Initial Placement ◽  
Group B

Catheters designed for chronic peritoneal dialysis have Dacron cuffs meant to protect the patient against bacterialinfection and catheter migration that may lead to a high peritonitis rate in case of extensive use. Peritoneal catheter isfixed by suturing the skin with a non-absorbable monofilament thread ranging from 4/0 to 2/0. The two types of suturesmost commonly used are Roman sandal and Chinese fingertrap. In this study we selected 44 dogs, both males andfemales with CKD (Chronic Kidney Disease) undergoing peritoneal dialysis. We have created two groups: first group(A) of 22 patients were treated using a peritoneal catheter for chronic treatment, with Roman sandal suture and thesecond group of 22 patients (B) were treated using a peritoneal catheter for chronic treatment, with Chinese fingertrapsuture. All patients from group A kept the catheters until the end of the treatment (22 out of 22, 100%). Eight out of14 patients (36.36%) from group B needed secondary suture. Four out of the eight patients (18.18%) form the group Bneeded secondary suturing because of the suture weakening. Three out of the eight patients (13.63%) form the groupB needed secondary suturing of the catheter because of the skin rupture at the initial placement spot of the suture. Oneof the eight patients (4.54%) form the group B needed secondary suturing of the catheter because of the catheterreplacement, due to the weakening of the suture and its lack of resistance to the aggression manifested by the patients

scholarly journals Histology and Immunohistochemistry of Radial Arteries Are Suggestive of an Interaction between Calcification and Early Atherosclerotic Lesions in Chronic Kidney Disease

Medicina ◽  
2021 ◽  
Vol 57 (11) ◽  
pp. 1156
Author(s):  
Aikaterini Lysitska ◽  
Nikiforos Galanis ◽  
Ioannis Skandalos ◽  
Christina Nikolaidou ◽  
Sophia Briza ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Vascular Calcification ◽  
Morphometric Analysis ◽  
Intima Media Thickness ◽  
Inflammatory Cells ◽  
Vascular Wall ◽  
Control Group ◽  
Group A ◽  
Group B

Background and Objectives: recent studies suggest an implication of immune mechanisms in atherosclerotic disease. In this paper, the interaction between inflammation, calcification, and atherosclerosis on the vessel walls of patients with chronic kidney disease (CKD) is described and evaluated. Materials and Methods: patients with stage V CKD, either on pre-dialysis (group A) or on hemodialysis (HD) for at least 2 years (group B), in whom a radiocephalic arteriovenous fistula (RCAVF) was created, were included in the study. The control group included healthy volunteers who received radial artery surgery after an accident. The expressions of inflammatory cells, myofibroblasts, and vascular calcification regulators on the vascular wall were estimated, and, moreover, morphometric analysis was performed. Results: the expressions of CD68(+) cells, matrix carboxyglutamic acid proteins (MGPs), the receptor activator of nuclear factor-kB (RANK) and RANK ligand (RANKL), and osteoprotegerin (OPG), were significantly increased in CKD patients compared to the controls p = 0.02; p = 0.006; p = 0.01; and p = 0.006, respectively. In morphometric analysis, the I/M and L/I ratios had significant differences between CKD patients and the controls 0.3534 ± 0.20 vs. 0.1520 ± 0.865, p = 0.003, and 2.1709 ± 1.568 vs. 4.9958 ± 3.2975, p = 0.03, respectively. The independent variables correlated with the degree of vascular calcification were the intensity of CD34(+), aSMA(+) cells, and OPG, R2 = 0.76, p < 0.0001, and, with intima-media thickness (IMT), the severity of RANKL expression R2 = 0.3, p < 0.0001. Conclusion: atherosclerosis and vascular calcification in CKD seem to be strongly regulated by an immunological and inflammatory activation on the vascular wall.

scholarly journals Calcium - Phosphate Index: Considerable Indicator in Different Stages of Chronic Kidney Disease

2012 ◽  
Vol 19 (Number 2) ◽  
pp. 3-6
Author(s):  
N Y Mili ◽  
Md. E Hoque ◽  
S Akhter ◽  
N S Lovely
Keyword(s):  
Chronic Kidney Disease ◽  
Calcium Phosphate ◽  
Kidney Disease ◽  
Serum Calcium ◽  
Phosphate Level ◽  
Ckd Stage ◽  
P Index ◽  
Group A ◽  
Group B ◽  
Serum Inorganic Phosphate

Since the early 1970s. calcium phosphate (Ca-P) index has been regarded as a risk factor for extra skeletal calcification. tumoral calcinosis and increased cardiovascular event and death. The general consensus was not to exceed 70 ing2h1Lt (5.6 unno1/1,2) in chronic kidney disease. The present study was done to find out the Ca - P index in different stages of (CKB) patients to assess the risks of the patients which can be understood and be negotiated. In this study 100 of previously diagnosed chronic kidney disease patients of different stages as CKD stage Ill. IV and stage V were included. Subjects were divided into three groups according to staging of chronic kidney disease : group A (stage 111) were 34 patients, group 8 (Stage IV) were 36 and group C (Stage V) were 30 patients. Mean serum inorganic phosphate level was in group A .5.41 + 2.49. group 8 8.17 + 3.63 and in group C 10.50 + 3.06. Mean serum Calcium level in three groups were in group-A 8.36± 0.74. group- B 8.10± 0.75 and in group- C was 7.43± 1.27 ). Ca - P index was calculated by multiplying the serum calcium and phosphate level. Mean Ca-P index was in group-A 49.39+ 22.95. group B-67.93+ 31.2 and in group-C 90.76+ 24.82. Statistical analysis was done betWeen these groups and it was signifimuly higher in group B than group A ( p< 0.06. group A is group 8). in group C than group A ( p< 0.00. group A vs group C) and in ,group C than group ft ( p< .002. group B vs group C). It was found that as the renal function deteriorates gradually the Ca P index increases and it is highly significantly higher in CKD — V patient than other stages.

scholarly journals Stenting in the common femoral vein does not increase posthrombotic syndrome or rethrombosis

2021 ◽  
Vol 42 (Supplement_1) ◽  
Author(s):  
S Krause ◽  
J M J R Telayna ◽  
R A Costantini ◽  
J M Telayna
Keyword(s):  
Stent Placement ◽  
Femoral Vein ◽  
Iliac Vein ◽  
Female Population ◽  
Common Femoral Vein ◽  
Group A ◽  
The Common ◽  
Group B ◽  
Venous Stents

Abstract Background In lower limbs deep venous thrombosis (DVT) scenario there is evidence that favours catheter guided invasive treatment. The treatment with stenting in the common femoral vein could be related with a diminished permeability in the inflow of the deep femoral vein. There is scarce data of the clinical follow up of this treatment. Purpose To analize and compare clinical and procedural outcomes in endovenous interventions that required stent placement in the common femoral vein because of residual lesion vs interventions that did no require such treatment. Methods From May 2010 to December 2020, 122 endovenous interventions were performed, within these 74 were DVT compromising the iliofemoral territory. Two groups were defined: Group A 28 (38%) that required stent placement in the common femoral vein and Group B 46 (62%) that did not required such treatment. Results Baseline characteristics were Group A vs Group B n (%) respectively: Median age 41.1±16.7 vs 40.5±18.8; female 23 (82) vs 27 (58); smoking 7 (25) vs 14 (30); cancer 1 (4) vs 7 (15); prior prolonged rest 7 (25) vs 14 (30); concomitant diagnosis of pulmonary embolism 7 (25) vs 17 (37). Within the female population 2 (7) vs 1 (2) were in puerperium; 6 (21) vs 6 (13) were under contraceptive therapy. Regarding the diagnosis of DVT 21 (75) vs 37 (80) were acute; 7 (25) vs 9 (19) were chronic. Compromised vessels were primitive iliac vein 21 (75) vs 38 (82); external iliac vein 6 (21) vs 18 (39); superficial femoral vein 11 (39) vs 8 (17); May-Thurner syndrome 14 (50) vs 20 (43). As regards the aspects of the intervention 15 (53) vs 34 (74) had a filter implanted in the inferior vena cava; thrombolytics were infused in 20 (71) vs 32 (70); manual thrombectomy was performed in 8 (27) vs 17 (37); mechanical thrombectomy 11 (39) vs 19 (41); pre dilation with balloon was performed in 22 (79) vs 39 (85); dedicated venous stents were implanted in 22 (78) vs 39 (85); not dedicated venous stents in 13 (46) vs 11 (24). Technique success was achieved in 28 (100) vs 45 (98) p=1; major bleeding occurred 0 vs 2 (4) p=0.5; rethrombosis 3 (10) vs 9 (20) p=0.25; intrahospital death 1 (4) vs 2 (4) p=1; early reintervention was needed 1 (4) vs 2 (4) p=1, radiation dose (min) 35.4±20.2 vs 30.1±17.0 p=0.2; Contrast (ml) 216.5±76.8 vs 217.3±90.8 p=0.9. During follow up (34.1±31.5 vs 22.3±16.4) image control was performed in 27 (96) vs 39 (85) p=0.23 with either doppler or chest computed tomography angiography. Post thrombotic syndrome (PTS) symptoms were classified with Villalta Score assuming that 0–4 points had no PTS, 5–9 points presented mild PTS, 10–14 points moderate PTS, &gt;14 points severe PTS, in Group A 1 (4) presented mild PTS vs Group B 2 (4) mild PTS p=1, 1 (2) moderate PTS. Conclusions Endovenous treatment with stent placement in the common femoral vein did not required more reinterventions nor had more complications nor had more PTS that the interventions without stent placement. FUNDunding Acknowledgement Type of funding sources: None. Table 1. Basal Characteristics Table 2. Outcomes

The Effect of Hemodiafiltration on Inflammatory Biomarkers in Comparison to High Flux Dialyzers in Prevalent Hemodialysis Patients

QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Gamal Elsayed Mady ◽  
Walid Ahmed Bichari ◽  
Mostafa Abdelnassier Abdelgawad ◽  
Lina Essam Khedr ◽  
Khaled Mohamed Rezk ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Uric Acid ◽  
Kidney Disease ◽  
Enzyme Linked Immunosorbent Assay ◽  
High Flux ◽  
Dialysis Unit ◽  
Statistical Significant Difference ◽  
Significant Difference ◽  
Group A ◽  
Group B

Abstract Introduction Inflammation in patients with ESRD undergoing HD is an increasing concern for physicians and has been related to increase the rates of morbidity and mortality. Interestingly, patients with ESRD in conventional HD have frequent infections and a suboptimal response to vaccines; this is probably related to an immune inflammatory disorder associated either with uremia and/or nutritional status. In addition to CRP, which seems to be the most important marker for the identification and control of inflammation in clinical practice, many other markers are also available for the evaluation of inflammatory state. Decreased renal clearance clearly accounts for higher levels of circulating cytokines, although increased production has also been described. Hemodiafiltration has been shown to improve cardio-protection and the immunologic system and reduces infection and mortality compared with conventional HD. A recent study showed that hemodiafiltration compared with conventional HD reduced the risk of mortality in ESRD patients. Analysis of pooled individual participant data from randomized controlled trials has shown survival benefits of high volume-HDF on all-cause mortality and especially cardiovascular mortality rate. The mechanisms that lead to improved outcomes are not clear, but it is thought that HDF may reduce the production of inflammatory mediators through the use of biocompatible dialysers and ultrapure dialysate and also improve clearance of larger molecular weight substances, many of which are associated with oxidative stress, inflammation and endothelial dysfunction. Objective The aim of this study is to detect, prospectively, the effect of 3 months dialysis with Hemodiafiltration on inflammatory and nutritional biomarkers in comparison to conventional dialysis with high flux dialyzer in stable HD patients. Patients and methods 30 adults aged 20-75 years who were selected from Dialysis Unit, Kobary El-Kobba Military Hospital. 30 male patients known to have chronic kidney disease and are on dialysis with high flux dialyzer more than 3 months were divided into 2 groups:15 Patients are shifted to be on dialysis with HDF and 15 Patients are continued to be on Regular Hemodialysis with high flux dialyzer. Full medical history and clinical examination. Anthropometric measurements and Laboratory investigations including Complete Blood Picture (WBCs, platelets, Hb), Coagulation profile PT, PTT&INR, Liver function tests (ALT, AST, T. Bilirubin and S. Albumin), Lipid profile (Triglycerides, total cholesterol, VLDL), S. creatinine, BUN, Na, K, Uric acid, Total Proteins, Serum Calcium, Serum Phosphorus, PTH, Serum ferritin, High sensitivity CRP (Enzyme- Linked Immunosorbent Assay (ELISA)) and IL6 (ELISA). Results The current study was conducted on 30 patients with chronic kidney disease on regular dialysis. The patients were divided into two groups A representing patients on hemodiafiltration (n = 15) and group B representing patients on dialysis with high flux dialyzer (n = 15). A high statistical significant difference (P &lt; 0.01) was found regarding K 4.3±0.6 meq/l in group A while it is 5.2±0.5 meq/l in group B, a high statistical significant difference (P &lt; 0.01) was found regarding phosphorus 4.6±1.0 mg/dl in group A while it is 6.1±0.9 mg/dl in group B and no statistical significant difference (P &gt; 0.05) was found as regard the uric acid. A statistical significant difference (P &lt; 0.05) was found regarding CRP 63.5±40.9 mg/dl in group A while it is 73.4±33.2 mg/dl in group B, a statistical significant difference (P &lt; 0.01) was found regarding IL6 85.3±37.6 mg/dl in group A while it is 156.7±151.9 mg/dl in group B after 3 months and no statistical significant difference (P &gt; 0.05) was found as regard those inflammatory markers before 3 months. A statistical significant difference (P &lt; 0.05) was found regarding CRP. A statistical significant difference (P &lt; 0.05) was found regarding IL6. Conclusion The present study revealed that there was no significant change in CRP and IL6 in patients on HDF compared to patients undergoing hemodialysis with high flux dialyzer before 3 months but there was a significant decrease in CRP and IL6 in patients on HDF compared to patients undergoing hemodialysis with high flux dialyzer after 3 months.

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