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논문분류	춘계학술대회 초록집
제목	Convection Volume and Hemodiafilter Selection in Post-Dilution On-line Hemodiafiltration
저자	Hiromi Hosoya
출판정보	2026; 2026(1):
키워드	post-dilution online (OL)-HDF, convection volume (CV) , α1-microglobulin (α1-MG), the choice of the hemodiafilter
초록	Objectives: High-dose HDF with a convection volume (CV) of ≥23 L provides superior removal of middle molecules, thereby potentially contributing to reduction in the mortality risk. We hypothesized that if a super high-flux hemodiafilter is used, it may not be necessary to secure a CV of ≥23 L. This study examined the removal efficiency of large-middle molecules using post-dilution online (OL)-HDF with a CV of 7–12 L by comparing three types of hemodiafilters used at our institution. Methods: This single-center retrospective observational study (Approval No. JSTB 2024-002) included patients undergoing post-dilution OL-HDF (CV 7–12 L, QB = 220–300 mL/min, QD = 350 mL/min) with FIX-S eco (n=19), MFX-UW eco (n=11), or ABH-PA (n=7). Previously collected laboratory data were analyzed to compare the solute removal efficiencies. The evaluated parameters included spKt/V and the reduction rates of creatinine, β2-microglobulin (β2-MG), and α1-microglobulin (α1-MG). Results: There were no significant differences in the spKt/V or reduction rates ofb creatinine among the three hemodiafilters. The reduction rate of β2-MG was significantly higher with MFX than with FIX (p = 0.017). Even within a CV range of 7–12 L, sufficiently high α1-MG reduction rates were achieved with all the three filters (FIX: 37.9 ± 5.7%; MFX: 40.5 ± 5.4%; ABH: 29.9 ± 5.8%), although the α1-MG reduction rate with ABH-PA was significantly lower than that with the other two hemodiafilters (vs. FIX: p = 0.0061; vs. MFX: p = 0.0292). Our findings suggest that even with a relatively low CV, high removal efficiency of large-middle molecules can be achieved by selecting the appropriate hemodiafilter. Conclusion: The removal efficiency of large-middle molecules in post-dilution OL-HDF is influenced not only by the convection volume, but also significantly influenced by the choice of the hemodiafilter.
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