| Theme | Prospects for Hemodiafiltration | |
|---|---|---|
| Title | The classification and characteristics of HDF therapy | |
| Publish Date | 2011/05 | |
| Author | Yoshiaki Takemoto | Department of Artificial Kidney, Osaka City University Medical School |
| Author | Toshihide Naganuma | Department of Artificial Kidney, Osaka City University Medical School |
| [ Summary ] | There are three hemodiafiltration methods which are divided into categories employing infused substitution fluids. The first method is predilution HDF in which the substitution fluid is infused before contact with the HDF filter. Predilution HDF employes on-line prepared substitution fluid. Therefore, a large amount of substitution fluid can be used. This method provides high efficacy removal of low molecular weight proteins. The second method is internal-dilution HDF, in which the substitution fluid is infused via the HDF filter. Internal dilution HDF is involved with internal filtration enhanced hemodialysis. With this method we may very easily provide HDF therapy without any additional devices because the dialyzer is designed to be incorporated within the dialysate through the membrane. Another factor concerning HDF therapy is that it may be divided into two categories, those which employ on-line prepared fluids and those which do not. On-line HDF systems employ on-line prepared substitution fluids. Off-line HDF systems use the commercially available substitution fluids. Another type of HDF therapy, termed acetate free biofiltration (AFBF), employs bicarbonate substitution fluids and acetate free dialysates. With AFBF, the harmful effects of acetates are completely eliminated. Therefore, this therapy improves the generally unstable condition of the patients treated. Overall, HDF therapy exhibits excellent characteristics for removal of low molecular weight molecular solutes and low molecular weight proteins. |
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