Brain Swelling During Dialysis

Acute Brain Volume Changes in Haemodialysis: Comparison of Low Flux Haemodialysis With Pre-dilution Haemodiafiltration

The proposed controlled, randomized study aims to compare pre-dilution hemodiafiltration (HDF) and low flux hemodialysis (HD) regarding acute changes in the brain.

The study consist of two examination days placed one week apart. 12 HD patients will be recruited to the study. The patients will be randomly placed in two groups: Pre-dilution hemodiafiltration during the first examination and low flux hemodialysis during the second day or vice versa.

Brain Magnetic Resonance Imaging (MRI) will be obtained before and after both treatments. The MRI-data will later be processed to estimate brain volume changes during the two types of treatment.

Inclusion Criteria:

• Age ≥ 18 years
• Informed consent
• Patient with end-stage renal disease (ESRD)
• Stabile hemodialysis treatment (Kt/V ≥ 1.3)
• No contraindications against MRI (pacemaker or other metal implants, claustrophobia, severe adiposity)
• Weight <140kg

Exclusion Criteria:

• Clinical signs of new structural, thromboembolic or vascular brain disease the last 3 month before entering the study
• Changes in corticosteroid treatment during the last two weeks
• Change in diuretics during the last two weeks
• Non-compliant with regard to salt and fluid intake
• Acute disease