Hemodiafiltration and clinical outcomes
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Abstract
Nowadays, the number of end stage renal disease (ESRD) patients tends to increase every year. The renal replacement therapy including hemodialysis, peritoneal dialysis and kidney transplantation demonstrates a benefit of improved quality of life and survival particularly kidney transplantation. Despite the techniques of hemodialysis have been developed in the past three decades, the all-cause mortality and cardiovascular mortality are still higher than general population. Therefore, to enhance the efficacy of uremic toxins clearance, hemodiafiltration method that combined diffusive with convective solute removal in a single therapy was developed. Recently, many clinical researches have been proven the advantages of hemodiafiltration over the conventional hemodialysis. However, the highly efficient hemodiafiltration requires the specific technique with a high-flux dialyzer, vascular access to provide the sufficient blood flow rate and ultrapure dialysate fluid. Because the adequate convection volume is the pivotal factor for decreased mortality in hemodiafiltration. This article reviews the principle of hemodiafiltration and clinical outcomes including mortality in dialysis patient, solute clearances, cardiovascular disease, and nutritional status.
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คณะอนุกรรมการกำหนดแนวทางการรักษาด้วยการฟอกเลือดและการกรองพลาสมาสมาคมโรคไตแห่งประเทศไทย. คู่มือการรักษาด้วยการฟอกเลือดและการกรองพลาสมาสำหรับผู้ป่วยโรคไต. 2018.