Review article

Online hemodiafiltration – new standard in the dialysis treatment?

Iva Mesaroš Devčić ; Poliklinika za hemodijalizu “Fresenius Medical Care”, Delnice
Ivan Bubić ; Zavod za nefrologiju i dijalizu, Klinika za internu medicinu, Klinički bolnički centar Rijeka
Sanjin Rački ; Zavod za nefrologiju i dijalizu, Klinika za internu medicinu, Klinički bolnički centar Rijeka

Abstract

Currently, more than a million patients worldwide are supporting renal function by
dialysis as a treatment of choice in the End-stage Renal Disease. Hemodialysis is one of the
modalities of renal replacement therapy. Hemodialysis removes nitrogenous and other waste
products, corrects electrolyte, water and acid abnormalities by diffusion, convection and ultrafiltration.
Hemodialiysis membranes which are presently in use are the synthetic membranes
of high biocompatibility (low-flux for conventional hemodialysis and high-flux for hemodiafiltration).
Dialysate is a solution of purified water and electrolytes and is used for balancing a
composition of blood. Hemodiafiltration is hemodialysis modality that combines principles of
hemodialysis and hemofiltration (diffusion and convection) to enhance removal of both, high
and low molecular weight uremic toxins. Online hemodiafiltration (OLHDF) offers production
of substitution fluid in dialysis machine from fresh dialysate, that’s why the technique of OLHDF
is simplified to use and economically acceptable. There are many clinical advantages of
OLHDF, some of them are: lower mortality risk, higher delivered dialysis dose, correction of
malnutrition, anti-inflammatory effect, improvement of blood pressure and hemodynamic
stability, better control of hyperphosphatemia, anemia and greater biocompatibility. Despite
of numerous clinical advantages, OLHDF is not still widely in use in maintenance hemodialysis
patients, mainly because of the higher price of high permeable filters. Although, any dialysis
modality, regardless of performance and efficiency will only partially restore integrity of renal
function, OLHDF seems to offer the most physiological way to enhance the removal of uremic
toxins and improvement of many comorbidities that are renal patients faced with. OLHDF is a
step forward to gold standard in renal replacement treatment.

Keywords

Cardioprotective dialysis; Hemodialysis; High-flux hemodialysis; Online hemodiafiltration

Hrčak ID:

63072

URI

https://hrcak.srce.hr/63072

Publication date:

8.12.2010.

Article data in other languages: croatian

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