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image/svg+xml Jakob Voss, based on art designer at PLoS, modified by Wikipedia users Nina and Beao Closed Access logo, derived from PLoS Open Access logo. This version with transparent background. http://commons.wikimedia.org/wiki/File:Closed_Access_logo_transparent.svg Jakob Voss, based on art designer at PLoS, modified by Wikipedia users Nina and Beao Blood Purificationarrow_drop_down
image/svg+xml Jakob Voss, based on art designer at PLoS, modified by Wikipedia users Nina and Beao Closed Access logo, derived from PLoS Open Access logo. This version with transparent background. http://commons.wikimedia.org/wiki/File:Closed_Access_logo_transparent.svg Jakob Voss, based on art designer at PLoS, modified by Wikipedia users Nina and Beao
Blood Purification
Article . 2015 . Peer-reviewed
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Is There an ‘Optimal Dose' of Hemodiafiltration?

Authors: Francisco, Maduell;

Is There an ‘Optimal Dose' of Hemodiafiltration?

Abstract

Background: Retrospective randomized clinical studies have shown that online hemodiafiltration (OL-HDF) is associated with a lower risk reduction of mortality than standard hemodialysis. Summary: In all of these large randomized studies, the convective volume seemed to be an important issue, but the optimal OL-HDF dose has not yet been defined. This article, to make a EUDIAL working group position, reviews the association between survival and convective volume, the minimum recommended replacement volume, the importance of the infusion flow rate, and the main limiting factors in achieving a high convective volume. Finally, the article discusses whether the convective dose should be normalized to body size. Key Messages: At present, there is sufficient scientific evidence to indicate that OL-HDF treatment reduces mortality risk and that it should be the first-line option in hemodialysis patients. It seems reasonable to recommend that patients should receive the highest possible convective dose and that the largest possible blood flow should be used to obtain the highest possible infusion flow rate. Based on the results of secondary analyses of the main clinical trials, the current recommendation of the optimal dose of OL-HDF, in the postdilutional mode and on a thrice-weekly treatment schedule, would be a convective volume higher than 23 liters/session. There is insufficient scientific evidence to recommend that the convective dose should be normalized to body size.

Keywords

Dialysis Solutions, Body Size, Humans, Kidney Failure, Chronic, Hemodiafiltration, Rheology, Survival Analysis, Blood Flow Velocity, Retrospective Studies

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selected citations
These citations are derived from selected sources.
This is an alternative to the "Influence" indicator, which also reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Citations provided by BIP!
popularity
This indicator reflects the "current" impact/attention (the "hype") of an article in the research community at large, based on the underlying citation network.
BIP!Popularity provided by BIP!
influence
This indicator reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Influence provided by BIP!
impulse
This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network.
BIP!Impulse provided by BIP!
22
Top 10%
Top 10%
Top 10%
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