Electrolyte Blood Press.  2016 Jun;14(1):1-4. 10.5049/EBP.2016.14.1.1.

Confronting Practical Problems for Initiation of On-line Hemodiafiltration Therapy

Affiliations
  • 1Department of Internal Medicine, Haeundae Paik Hospital, Inje University College of Medicine, Busan, Korea. kyw8625@chol.com

Abstract

Conventional hemodialysis, which is based on the diffusive transport of solutes, is the most widely used renal replacement therapy. It effectively removes small solutes such as urea and corrects fluid, electrolyte and acid-base imbalance. However, solute diffusion coefficients decreased rapidly as molecular size increased. Because of this, middle and large molecules are not removed effectively and clinical problem such as dialysis amyloidosis might occur. Online hemodiafiltration which is combined by diffusive and convective therapies can overcome such problems by removing effectively middle and large solutes. Online hemodiafiltration is safe, very effective, economically affordable, improving session tolerance and may improve the mortality superior to high flux hemodialysis. However, there might be some potential limitations for setting up online hemodiafiltaration. In this article, we review the uremic toxins associated with dialysis, definition of hemodiafiltration, indication and prescription of hemodiafiltration and the limitations of setting up hemodiafiltration.

Keyword

Hemodiafiltration; Water; Dialyzer; Limitation

MeSH Terms

Acid-Base Imbalance
Amyloidosis
Dialysis
Diffusion
Hemodiafiltration*
Mortality
Prescriptions
Renal Dialysis
Renal Replacement Therapy
Urea
Water
Urea
Water

Reference

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