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The Donnan equilibrium is still valid in high-volume HDF.
Int J Artif Organs
December 2024
Global Systems Engineering, VS Machines, Care Enablement, Fresenius Medical Care Deutschland GmbH, Schweinfurt, Bavaria, Germany.
Clinical studies have shown that hemodiafiltration reduces morbidity and mortality of dialysis patients compared to hemodialysis alone. This is attributed to its superior middle molecule clearance compared to standard hemodialysis. However, doubts arose as to whether a high convective flux through the dialyzer membrane has an influence on the equilibrium concentration of small ions, especially that of sodium.
View Article and Find Full Text PDF[Convective Methods versus Diffusive Methods: Defined Superiority?].
G Ital Nefrol
October 2024
U.O.C. di Nefrologia , Dialisi ed Ipertensione IRCCS Azienda Ospedaliero-Universitaria di Bologna.
The technique of dialysis has seen enormous advancements over the past fifty years, evolving from an initial phase, primarily based on diffusion through a semipermeable membrane to the current preference for high-efficiency convection, involving the removal of several liters of ultrafiltrate. Diffusive dialysis, due to its relative simplicity in execution, has allowed the treatment of millions of individuals with ESRD, ensuring them a certain quality of life. However, it is not considered optimal in terms of survival and has some complications inherent to the uremic state.
View Article and Find Full Text PDFHaemodiafiltration versus haemodialysis for kidney failure: an individual patient data meta-analysis of randomised controlled trials.
Lancet
October 2024
Department of Nephrology & Hypertension and Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, Netherlands.
Background: High-dose haemodiafiltration has been shown, in a randomised clinical trial, to result in a 23% lower risk of mortality for patients with kidney failure when compared with conventional high-flux haemodialysis. Nevertheless, whether treatment effects differ across subgroups, whether a dose-response relationship with convection volume exists, and the effects on cause-specific mortality remain unclear. The aim of this individual patient data meta-analysis was to compare the effects of haemodiafiltration and standard haemodialysis on all-cause and cause-specific mortality.
View Article and Find Full Text PDFEffect of hemodiafiltration and hemodialysis on mortality of patients with end-stage kidney disease: a meta-analysis.
BMC Nephrol
October 2024
The First People's Hospital of Huzhou, No. 158, Guangchang Hou Road, Huzhou, Zhejiang Province, 313000, People's Republic of China.
Introduction: Previous randomized controlled trials (RCTs) and meta-analyses comparing Hemodiafiltration (HDF) with conventional hemodialysis (HD) on the effectiveness of HDF for mortality in end-stage renal disease (ESRD) patients have yielded contrasting results. Importantly, we sought to compile the available information to provide the most up-to-date and reliable evidence.
Methods: We systematically searched PubMed, Embase and Cochrane Library for RCTs up to January 14, 2024.
[The Evolution of Hemodialysis in Chile: Is Hemodiafiltration the Next Step?].
Rev Med Chil
December 2023
Clínica Redsalud Vitacura, Santiago, Chile.
Hemodialysis began in Chile during the latter half of the 20th century, primarily targeting individuals with acute renal failure. With time, dialysis facilities emerged across diverse regions of the nation, covering hospitals and private centers. This expansion widened dialysis access to chronic patients, culminating in universal coverage through the AUGE plan.
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