Hemodiafiltration - a New Era by H. Kawanishi, A.C. Yamashita

By H. Kawanishi, A.C. Yamashita

Hemodiafiltration (HDF) for the remedy of end-stage renal sickness sufferers is predominantly played in ecu nations and in Japan, with a few changes in strategy corresponding to price of blood circulation and dialysis fluid supply structures. the focus of this publication is at the scientific significance of on-line HDF, the thoughts of that have been re-evaluated with the advent of tremendous high-flux membrane dialyzers. After a short advent into the historical past of HDF, contemporary advances and medical reports of HDF are summarized, together with water quality controls for dialysis fluid, outfitted process for secure use, medical merits, and theoretical elements of HDF. additionally, on the finish of every bankruptcy researchers and scientists speak about difficulties into which extra study is required. Clinicians and scientists interested in the therapy of end-stage renal affliction sufferers will locate this ebook a vital resource of data. furthermore, it could actually additionally function a textbook should you are making plans to begin HDF of their clinics or who're learning blood purification remedies in clinical faculties, nursing colleges or even in engineering faculties relating to clinical applied sciences.

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8 m2) that allows convective and diffusive exchange from dialysate. The substitution fluid produced by cold sterilization from the fresh dialysis fluid is infused either on predilution mode or on postdilution mode according to the position of the dialyzer [43]. Hemodiafiltration with endogenous reinfusion (HFR) derives from PHF. The main feature of HFR is the online regeneration of the ultrafiltrate by an Optimizing Safety and Efficacy of Hemodiafiltration 33 adsorbing device [44]. The regenerated ultrafiltrate is then reinfused as an endogenous substitution fluid [45].

1 Assumption of convection volume. 2 >50% of the sessions HDF. 3 Ultrafiltration volume or rate. 4 Flow rate substitution fluid. 5 Only in the group that started on HD. 6 In HF-HD vs. olHDF. 7 In LF-HD vs. HF-HD or HDF. 42 den Hoedt · Mazairac · van den Dorpel · Grooteman · Blankestijn Convection volume Mortality Inflammation CRP Remarks IL-6 Kt/V β2-MG ns. s. s. s. s. ↓ Effect of HDF on Mortality, Inflammation and Quality of Life ↓ = = ↓ 43 may contribute to a state of persistent inflammation [26].

There is a need for better understanding of the mechanisms involved, as well as further confirmation of these encouraging findings with prospective controlled trials. Nevertheless, HDF appears a promising therapy that likely will improve patient outcomes. Based on these considerations, HDF has the potential to become the new gold standard for dialysis in the years to come. Copyright © 2011 S. Karger AG, Basel Hemodiafiltration: From Origin to Today Hemodiafiltration (HDF) is a renal replacement technique combining diffusion and convection to enhance solute removal in a wide spectrum of molecular weights, first introduced by Henderson [1] in 1967.

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