| Theme | Progress and Future in Blood Purification | |
|---|---|---|
| Title | HDF, push and pull HDF, on-line HDF, AFBF | |
| Publish Date | 1999/01 | |
| Author | Hisashi Ishida | Department of Internal Medicine, Matsue Red Cross Hospital |
| Author | Atsushi Niii | Dialysis Center, Matsue Red Cross Hospital |
| Author | Akio Kurahashi | Department of Internal Medicine, Matsue Red Cross Hospital |
| Author | Yoshinori Urushidani | Department of Internal Medicine, Matsue Red Cross Hospital |
| Author | Tadashi Nabika | Department of Internal Medicine, Matsue Red Cross Hospital |
| Author | Hiroshi Fukuba | Department of Internal Medicine, Matsue Red Cross Hospital |
| Author | Yuji Fukuda | Dialysis Center, Matsue Red Cross Hospital |
| Author | Keiko Ihara | Clinical laboratory, Matsue Red Cross Hospital |
| Author | Yuko Sakamoto | Clinical laboratory, Matsue Red Cross Hospital |
| Author | Akihiko Tanaka | Shigei Medical Research Hospital |
| Author | Hiroyuki Omori | Shigei Medical Research Hospital |
| [ Summary ] | In dialysis therapy, the selection of an HD method and HD membrane is one of the most important matters of consideration. In HD methods solutes are removed through pores in the membrane along with dilution. Small molecular substances are easy to remove, but larger molecular ones are harder to remake. On the other hand, larger molecular solutes such as beta-2-microglobulin are removed morely easily with HF than with HD, because HF purification is based on the conbection of larger amounts of replenished solution. Hemodiafiltration is a combined method, using HD and HF to remove smaller and larger molecular substances. In this paper, we mentioned several kinds of HDF i.e.: bottle/bag, on-line and push&pull methods. We plan to summarize the clinical efficiencies of the bottle/bag type three hour HDF in our more than ten years' of clinical experience and the results of HDF therapy in my hospital. We have achieved lower beta2-MG plasma levels, more frequently with bottle/bag type HDF therapy than with HD or the high performance membrane(HPHD)methods. By achieving lowered plasma beta2-MG levels, we decreased the retardation of the median nerve conduction velocities through the carpal tunnel and the incidence of carpal tunnel syndrome; one of the long term complications of HD. Furthermore, we discussed the efficacy of other HDF methode, i.e.; on-line, push & pull and acetate free biofiltration (AFBF), and concluded that the on-line HDF or AFBF types should be recommended as methods of HDF in the near future. |
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