RESUMEN
Many hypotheses could explain the mortality decrease observed using hemodiafiltration, such as reduction of intradialytic hypotension and more efficient toxin removal. We led a systematic analysis of representative uremic toxin removal with hemodialysis (HD), online postdilution hemodiafiltration (postHDF) and online predilution hemodiafiltration (preHDF), in a single-center crossover and prospective observational study. The primary outcome was the reduction ratio of uremic toxins of the three categories defined by the Eutox group. Twenty-six patients were treated by those three techniques of extra renal epuration. Mean Kt/Vurea was not different between the treatment methods. Mean reduction ratio of beta2microglobulin was significantly higher for both HDF treatments than for HD (p < 0.001). Myoglobin, kappa, and lambda free light chain reduction ratio was significantly different between the modes: 37.75 ± 11.95%, 45.31 ± 11% and 61.22 ± 10.56%/57.21 ± 12.5%, 63.53 ± 7.93%, and 68.40 ± 11.79%/29.12 ± 8.44%, 34.73 ± 9.01%, and 45.55 ± 12.31% HD, preHDF, and postHDF, respectively (p < 0.001). Mean protein-bound solutes reduction ratio was not different between the different treatments except for PCS with a higher reduction ratio during HDF treatments. Mean albumin loss was always less than 2 g. HDF improved removal of middle molecules but had no effect on indoles concentration without any difference between synthetic dialysis membranes.
RESUMEN
INTRODUCTION: Morocco stays far behind other countries in the domain of organ donation and transplantation. Improving the knowledge of Moroccan students, about organ donation and transplantation, can be a key factor in the development of transplant activity. The aim of this study is to evaluate the knowledge, attitudes and beliefs of students concerning organ donation and transplantation. MATERIALS AND METHODS: The opinion survey was conducted in Marrakech city, with four high education structures with a pre-established questionnaire. The survey questions answered four main themes, which are: the evaluation of knowledge, the opinion and attitude of citizen, the explanation of refusal and the propositions to encourage organ donation in Morocco. RESULTS: Hundred percent of surveyed subjects answered the questionnaire. Among them, 40.3% were men. The middle age was 21.5 years. Out of 503 surveyed students, 89.4% were aware of organ transplant in Morocco. A quarter of students believed that removal and transplant acts were realized just in public health establishments, which have the authorization. Two persons out of 3 were able to identify transplantable organs and tissues. More than half accepted to donate their organs after death. The religious reason was in the head list of refusal determinants of organ donation after death, with a prevalence of 39.7%. CONCLUSION: Young Moroccans have limited knowledge relating to organ donation. The development of this therapy needs to establish an adequate project of information and motivation of general population.