The Japanese Journal of Clinical Dialysis Vol.33 No.5(3-1)

Theme Online hemodiafiltration (HDF) -- expansion and issues
Title Selection of hemodiafilters
Publish Date 2017/05
Author Sadatoshi Osawa Kushiro Urology Clinic
[ Summary ] There are two major subjects concerning HDF therapy. One is to increase removal volumes of large molecular weight substances which are difficult to remove with HD therapy. The other is to prevent intradialysishypotension. The greatest advantage of online HDF therapy is the aggressive removal of middle and large molecular weight substances by high volume convection. The methods for hemodilution are predilution methods and postdilution method include two methods which have difference in their hemoconcentration ratios within hemodiafilters. During online HDF therapy, the ultrafiltratation rate of hemodiafilters decreases and TMP increases. Therefore, hemodiafilters are required to have high ultrafiltration rates and high removal performance for middle and large molecular weight substances, while providing only slight amount of albumin leakage. When determining criteria for hemodiafilter, we should consider the differences between hemodilution methods, stability of dialysis membrane performance and tolerance ranges of albumin leakage.
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