TITLE:
Potassium Removal during Conventional Hemodialysis and Predilution Online Hemodiafiltration at Two Dialysate Potassium Concentrations
AUTHORS:
Konstantinos S. Mavromatidis, Irini M. Kalogiannidou, Emine S. Impis, Pelagia A. Kriki
KEYWORDS:
Dialysate Potassium, Dialysate Glucose, Conventional Hemodialysis, Predilution Online Hemodiafiltration, Potassium Removal
JOURNAL NAME:
Journal of Biosciences and Medicines,
Vol.14 No.10,
October
26,
2026
ABSTRACT: The balance of potassium, which is normally regulated mainly by the amount ingested with food and the kidneys, in hemodialyzed patients also depends on the amount removed through the dialysis filter. Of course, both the increase in its levels in the blood (hyperkalemia) and its decrease (hypokalemia) are important. However, for most doctors, the greatest risk lies in the increase in its levels, although in hemodialyzed patients, hypokalemia is also a significant risk factor for death. In this prospective study, 10 patients (6M, 4F), aged 61 to 88 years old (median 75 years), who had been on dialysis for 6 to 567 months (mean ± SD = 148 ± 197), were included. The amount of potassium removed during dialysis was determined depending on the potassium of the dialysate (2.0 or 3.0 mmo/L), both in conventional hemodialysis (Groups A and B) and in predilution online hemodiafiltration (Groups C and D) and was found to be significantly higher in both cases at the lower potassium concentration of the dialysate (in conventional hemodialysis 61.7 ± 26.7 Vs 36.0 ± 17.3, p = 0.005 and in online hemodiafiltration 66.9 ± 18.6 Vs 23.6 ± 17.0, p = 0.0005). As can be seen, a numerically greater potassium removal was recorded in online hemodiafiltration. Regarding the glucose of the dialysate, even though everyone used a glucose dialysate, and a varying amount of glucose gain or loss was found in the patients, this did not appear to affect the levels of potassium removed with each dialysate potassium and each method. It is concluded that the dialysate potassium, both in conventional hemodialysis and in predilution online hemodiafiltration, significantly affects its removal amount (more in the latter) and the amount of glucose gain or lost during the session (in dialysis with both methods used), does not affect the potassium removed through the filter.