| [ Summary ] |
Hemodiafiltration (HDF) requires dialysis fluids and substitution fluids. It is easy for on-line HDF to do large volumes of fluid replacement therapy. However, dialysis fluids (D) and substitution fluids have the same composition, because substitution fluid is made of part of the fresh ultra-pure dialysis fluid. On the other hand, when performing off-line HDF we can deliberately select the composition of the fluids. This is especially so with AFBF when we can clearly divide the roles they will play. Substitution fluids for off-line HDF primarily uses sodium bicarbonate as a buffer with the concentration of HCO3 being 35 mEq/l. Acetate-free dialysis fluids and substitution fluids are attracted to each other, however, citric acid loading is inevitable. AFBF exhibits neither acetate nor citric acid loading. Commercial substitution fluids have been developed for biocompatibility, and there is manufacture whose acetate concentration is 0.5 mEq/l. Off-line HDF is one possible choise when conditions do not require large volumes for replacement therapy. |