| Theme | New Modalities in Blood Purification Therapies | |
|---|---|---|
| Title | Hemodiafiltration treatment using reverse filtrated dialysate (ultra-purified dialysate) | |
| Publish Date | 2005/02 | |
| Author | Takashi Sato | Sumiyoshi Clinic Hospital |
| [ Summary ] | Hemodiafiltration treatments (HDF) using reverse filtrated dialysate are divided into the following : (1) Internal filtration enhanced hemodialysis (IFEHD), (2) On-line HDF, and (3) Push and pull HDF (P / P HDF). Since these HDF treatments are carried out by using a dialysate which has been reverse-filtered through a membrane (i.e. dialyzer and / or endotoxin cutting filter) as a substitution fluid, strict management is needed for production and water quality management of reverse-filtrated dialysates. With IFEHD, one feature is that HDF can be enforced by the same technique as the usual HD, although the volume of filtrated dialysate cannot be measured, which poses a problem. Furthermore, with on-line HDF and P / P HDF, the massive removal of large molecular weight substances can be attained by extensive filtration. Clinically, it has been reported that on-line HDF and P / P HDF are effective for dialysis related complications, such as an erythropoietin resistance anemia, joint pain, feelings of mental irritation, restless legs syndrome, dialysis related hypotension etc. Also, in the long run, these HDF treatments may be effective in the prevention of arteriosclerosis, for improvements in states of malnutrition and improving general prognoses for dialysis patients. In relation to these clinical improvements, a multi center study is still required. |
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