Potassium Removal by Predilution Online Hemodiafiltration Compared with Conventional Hemodialysis

Background: Potassium balance is an important concern of nephrologists when treating patients on dialysis. However, the amount of potassium removed by predilution online hemodiafiltration has not been investigated in prior studies. The purpose of the study was to investigate the amount of potassium removed by predilution online hemodiafiltration compared to conventional hemodialysis.

Methods: This study traced the amount of potassium removed in each session among 23 patients undergoing both conventional hemodialysis and predilution online hemodiafiltration. The effect of the concentration of potassium and bicarbonate in the dialysate was evaluated. Finally, the influence of β-blocker use on potassium homeostasis was also assessed.

Results: There was no difference in mean serum potassium levels between conventional hemodialysis and predilution online hemodiafiltration [P = NS (nonsignificant)] before and 1 hour after the end of the session (P = NS). Significantly less potassium was removed in conventional hemodialysis compared to predilution online hemodiafiltration (P < .0001). The amount of potassium removed in conventional hemodialysis was lower in the high potassium dialysate group (P < .02) and in those undergoing predilution online hemodiafiltration (P < .03). The use of β-blockers was associated with higher predialysis serum potassium levels in the group of conventional hemodialysis.

Conclusion: The present study shows that in predilution online hemodiafiltration, much more potassium is removed than in conventional hemodialysis. Potassium removal is greater with low potassium dialysate in both methods. The use of β-blockers is associated with higher predialysis serum potassium levels in conventional hemodialysis, while dialysate bicarbonate concentration does not substantially affect the amount of potassium removed during dialysis.

Cite this article as: Mavromatidis KS, Kalogiannidou IM, Passadakis PS. Potassium removal by predilution online hemodiafiltration compared with conventional hemodialysis. Turk J Nephrol. Published online April 18, 2024. doi:10.5152/turkjnephrol.2024.23534.