| [ Summary ] |
Therapeutic modalities for chronic dialysis should be decided on not only based on the existence of dialysis hypotension or dialysis related amyloidosis, but also in relation to multiple patient complaints, such as itching and irritability. It is important to balance the diffusion, convection and adsorption of uremic toxins to establish adequate therapeutic modalities. On-line HDF and protein adsorptive dialysis membranes are useful tools in achieving treatment goals. Changes in therapeutic conditions must be initiated to improve treatment. These changes include control of blood flow rates and substitution fluid flow rates improved dialysis membranes, improved dialysis schedules and adapting to patient complaints. Improvement of symptom is the most important parameter used to assess the quality of modalities. The efficacy of any modality should be analyzed not only by the level of serum beta2 microglobulin and reduction rates, but also by the total amount of albumin leakage through dialysis sessions. |