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ORIGINAL ARTICLE
Year : 2016  |  Volume : 16  |  Issue : 3  |  Page : 79-88

Effect of a single session of haemodiafiltration on nerve conduction, interleukin-6 and β2-microglobulin


1 Department of Internal Medicine and Nephrology, Kasr Al-Aini School of Medicine, Cairo University, Cairo, Egypt
2 Department of Clinical Neurophysiology, Kasr Al-Aini School of Medicine, Cairo University, Cairo, Egypt

Correspondence Address:
Rabab M Ahmed Mahmoud
Assistant Lecturer of Internal Medicine and Nephrology, Kasr Al-Aini School of Medicine, Cairo University, Cairo
Egypt
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/1110-9165.197382

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Background β2-Microglobulin (β2-MG) is a uremic toxin that is retained in patients with end-stage renal disease. Interleukin-6 (IL-6) besides being an inflammatory marker has emerged as an independent predictor of mortality in end-stage renal disease patients. Objectives The aim of the present study was to investigate the effect of online haemodiafiltration (OL-HDF) by one session per week on the serum level of both IL-6 and β2-MG and to evaluate its effect on the changes in nerve conduction in patients on chronic haemodialysis (HD). Patients and methods Sixty patients on regular conventional HD for more than 5 years were subjected to one session of OL-HDF by using the ‘Gambro AK 200 ULTRA’ system for 4 h and two sessions of HD for 4 h per week with a follow-up for 3 months. Furthermore, urea reduction ratio was measured during one HD and one HDF session, serum β2-MG and IL-6 reduction ratio were measured during one HD and one HDF session, and during follow-up, the serum β2-MG level and IL-6 level were measured at four time intervals. Nerve Conduction Study (NCS) was done at the start of the HDF treatment and follow up 3 months post HDF treatment. Results Urea reduction ratio% was significantly higher with HDF than with HD (75.6 vs. 66.9%) and this difference was statistically significant (P<0.001). Reduction ratio of β2-MG level was 72.2% with HDF versus 26.6% with HD and this difference was statistically significant (P<0.001). The results of motor conductivity testing showed significantly higher nerve conduction velocity in post-HDF in comparison with pre-HDF in right median nerve (P<0.001) and in left peroneal nerve (P<0.001). The mean value of sensory response in amplitude as well as in nerve conduction velocity in right median nerve and left median nerve were significantly higher after HDF treatment period (P<0.05). Conclusion The OL-HDF had a good effect on clearance of β2-MG at the level of one session, at the level of follow-up for 3 months, the serum level of β2-MG did not significantly changed. Also improvement in some aspects of nerve conduction, but the level of IL-6 in OL-HDF increase.


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