Water Soluble Vitamins and Trace Elements Loss in Hemodiafiltration Patients
Condition: Chronic Hemolysis
MeSH terms: Hemolysis
Study type: Observational

Summary: 
      End stage renal disease is a severe pathology in which some toxic waste and an excessive
      amount of water can accumulate in the human body with life threatening consequences.
      Maintenance hemodialysis is one of the possible treatment for this disease.

      Hemodialysis filter the blood through a membrane according to a dialysis bath and so can be
      able to purify the blood of the toxic waste.

      Otherwise, since the 1980s, the investigator know that patient in maintenance hemodialysis
      can have some deficiency in water soluble vitamins and trace elements. Mechanisms of the
      deficiency are multiple (a decreased of food intake, a diminution of the appetite, digestive
      malabsorption du to medics and comorbidities and loss in hemodialysis).

      Impact of this deficiency have an important impact on vital prognosis for these patients.
      These nutrients are essential for AND synthesis, mechanism of inflammation, cells membranes
      synthesis, etc. DOPPs study in 2004 have shown a decreased of 16% in the mortality within 4
      years with supplemented patients. Also, since this study, international recommendations were
      wrote in 2009, then in 2020, in order to supplement in vitamins and trace elements patients
      in maintenance conventional hemodialysis.

      Despite these recommendations, some supplementary efforts are necessary, especially since
      online hemodiafiltration, a new process, is widely available and used in particular in
      Europe. This process combines 2 phenomena, diffusion and convection, through high-flux
      membranes. This process can remove a large quantity of molecule present in blood and
      especially the middle-molecule. In return, a more important quantity of water soluble
      vitamins and oligo-elements could be removed by this technique.

      Also, the investigator would like to measure this loss of vitamins and trace-elements in
      patients with maintenance online post-dilution hemodiafiltration process with dialysate
      sample and blood concentrations measured (usual patient monitoring) during the session.
    


Intervention name(s): Water-soluble vitamins and trace elements measures
Intervention type(s): Biological
Intervention description(s): We would like to measure water-soluble vitamins (B1, B6, B9, B12, C) and trace elements (zinc, selenium) in blood and dialysate for the patients treated by online post-dilution hemodiafiltration patients. There measures on blood are done systematically during the half-yearly report of our patients in our hemodialysis center. Only results are collect for the study.
Intervention MeSH terms: Trace Elements; Micronutrients
Observational model: Cohort
Time perspective: Cross-Sectional
Sampling method: Non-Probability Sample
Study population: 
        Maintenance hemodialysis patients who are treated in nephrology unit at Centre Hospitalier
        de Lyon Sud with online hemodiafiltration process
      
Biospecimen description: 
      This study collect and analyse dialysate sample through a device called sampler was developed
      by the THERADIAL® company. Sampler collect continuously during the dialysis session, one
      hundred of the effluent liquid (ie a calibrated sample of dialysate) before it is eliminated
      in the sewer. The dialysate samples will be analyzed by the Lyon Sud biochemistry laboratory
      immediately after the end of the session