Intermittent and short daily hemodialysis increase HGF plasma levels and diminish HCV viral load

Decrease of HCV viral load and HGF plasma levels increase have been related to HD sessions. Beneficial effects of HGF stimulation in HD on the outcome of HCV liver disease have been described. Aim was to analyze potential differences between intermittent (3 × week) and short daily (6 × week) HD, examining differences between HCV+ and – pts. We studied 41 pts from 2 HD centres, 26 on intermittent HD (6 on line HF), 8 HCV+, and 15 on short‐daily HD with 4 HCV+ 40 pts used synthetic HD membranes (low‐flux and high‐flux). Among HCV + we determined viral load by Amplicor (Roche) pre‐ and post‐ HD. All pts were studied for HGF levels (ELISA) baseline, 15 min, end, and at start of the following session viral load is significantly higher preHD and decreases over session. High‐flux membranes were more efficient in reducing viremia (67% vs 45%), which level was higher pre‐ and post‐HD principally in patients using low‐flux membranes. Viremia in DHD is lower than in intermittent (470067.3 ± 663974.5 vs 1015695.5 ± 1202679.0). HCV+ HCV− p HGF baseline 3261.3 ± 1904.5 2186.5 ± 815.7 0.01 HGF 15 min 8000.0 ± 0.0 7774.0 ± 1129.8 ns HGF end 6142.5 ± 2262.3 4443.7 ± 2515.7 0.03 HGF start 3391.0 ± 1680.6 2311.7 ± 633.6 0.007 HGF at baseline, at the end of the session, and starting the following one was significantly higher in HCV + patients. Maximum increase appears always at 15 min. HGF levels were significantly higher in daily HD than intermittent. Of the 14 patients who showed HGF after session higher than 8000, 8 were HCV+(3 in DHD, 5 high flux), 6 were HCV−(5 DHD and 3 high flux), 14 pts finished HD session with HGF>8000, 8HCV+(3 DHD, 5 high flux) and 6HCV−(5 DHD, 4 high‐flux). HGF stimulation appears in daily and intermittent HD, with higher level in the latter; HCV+ showed higher HGF vs negative, independently from the HD frequency; HCV viral load diminishes in all HD sessions, more in those with high‐flux membranes. Short‐daily HD with high‐flux synthetic membranes seems the best option for HCV+ patients, and when performed in home precludes nosocomial transmission.