TY - JOUR T1 - Protein-bound toxins: Added value in their removal with high convective volumes JO - Nefrología (English Edition) T2 - AU - Abad,Soraya AU - Vega,Almudena AU - Quiroga,Borja AU - Arroyo,David AU - Panizo,Nayara AU - Reque,Javier Eduardo AU - López-Gómez,Juan Manuel SN - 20132514 M3 - 10.1016/j.nefroe.2016.05.011 DO - 10.1016/j.nefroe.2016.05.011 UR - https://revistanefrologia.com/en-protein-bound-toxins-added-value-in-articulo-S2013251416301468 AB - Chronic kidney disease is associated with an increased risk of cardiovascular events. In recent years, protein-bound toxins have become more important due to their association with increased morbidity and mortality, characterised by inadequate clearance during dialysis. The purpose of this study is to assess the influence of high convective volumes on postdilution online haemodiafiltration (OL-HDF) on the removal of medium-sized molecules, small molecules and protein-bound molecules. Material and methodsIn forty postdilutional OL-HDF sessions, the reduction rates of toxins of different molecular weights were measured in 13 patients, including protein-bound molecules such as p-cresyl sulphate, indoxyl sulphate and homocysteine. ResultsTotal convective volume was 28.3 (5.1)l (range 16.3–38.0l). Mean reduction rate of protein-bound molecules was 44.4% (15.7%), 48.7% (14.1%) and 58.6% (8.8%) for p-cresyl sulphate, indoxyl sulphate and homocysteine, respectively. Moreover, a statistically significant direct association was found between the reduction rates of all three molecules, the replacement volume and the Kt/V. ConclusionHigh convective volumes during postdilution OL-HDF are associated with increased removal of protein-bound uraemic toxins. ER -