New dialysis modality

[kidneydoc]

http://www.allkidney.com/2009/11/new-dialysis-modality-daily-ol-hdf.html

A relatively new dialysis modality is now getting more exposure its called daily online demodiafiltration. Studies are sparse but this study is interesting because the growth retardation in children that occur on dialysis may have been improved. If that is so this may imply a new level of adequacy in terms of what can be achieved by dialysis. Or it could just be hype. Anyway time will tell enjoy.

[Darthvadar]

Thanks Roger....

As always, something to mull over...

Keep the articles coming, please!...

God bless...

Darth...

[Rerun]

Interesting.  If they combine the daily dialysis with this extra sterile fluid process then how do we know which one is making the difference?

We know daily dialysis has better results.

I'd like to see this sterile fluid removal process done on the 3x a week just to see if there is any improvement in numbers.

Thanks Hemodoc

[kidneydoc]

Essentially the diafiltration process which is the addition of replaceent fluid directly into the dialyser is a method of increasing clearance. Dialysis done entirely by that method is no longer called dialysis it is  called CVVH or hemofiltration for short.

so this method is a combination of two methods.

standard hemodialysis that we all know and love
as well as hemofiltration usually done continuously in the ICU when necessary (24 hour)

creating hemodiafiltration. an additive effect is therefore expected.

[Zach]

Some of our IHD members from the UK have been on hemodialfiltration for quite a while.

In fact, current British Guidelines states:

"Guideline 2.2
In order to exploit the high permeability of high-flux membranes, on-line haemodiafiltration or haemofiltration should be considered.
The exchange volumes should be as high as possible, with consideration of safety. (Evidence level II)."