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Haemodiafiltration: Principles, Technique, and Advantages over Conventional Haemodialysis

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Pediatric Dialysis

Abstract

Conventional haemodialysis (HD) is a widely used therapy for the replacement of renal function in children with end-stage kidney disease (ESKD). HD is based on diffusive transport of solutes across a semipermeable membrane and is effective in removing small uraemic retention solutes, such as urea, and correcting electrolyte and fluid imbalances. However, it is poorly suited to the removal of larger uraemic retention solutes, such as β2-microglobulin, even when high-flux membranes are used. As the importance of larger uraemic toxins has become recognised, the need for alternative therapies that provide better removal of those solutes has become evident. This insight led to the development of convective therapies, haemofiltration, and combined convective and diffusive therapies, haemodiafiltration (HDF) in the 1970s. Today, HDF is used in treating both acute kidney injury (as continuous veno-venous HDF) and ESKD.

In this chapter, we discuss the principles of HDF, the technique and practical aspects of performing HDF in children, relevant paediatric and adult studies, and the advantages of HDF over conventional HD.

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Authors and Affiliations

  1. Department of Paediatric Nephrology, Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK

    Rukshana Shroff

  2. Paediatric Nephrology, University Hospital Southampton NHS Foundation Trust, Southampton, UK

    Evgenia Preka

  3. Pediatric Nephrology Department, Hôpital Femme Mère Enfant, Hospices Civils de Lyon, Bron, France

    Bruno Ranchin

Authors
  1. Rukshana Shroff
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  2. Evgenia Preka
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  3. Bruno Ranchin
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Corresponding author

Correspondence to Rukshana Shroff .

Editor information

Editors and Affiliations

  1. Department of Pediatrics, University of Missouri-Kansas City, School of Medicine, Division of Pediatric Nephrology, Children’s Mercy Kansas City, Kansas City, MO, USA

    Bradley A. Warady

  2. Stanford University School of Medicine, Division of Pediatric Nephrology, Department of Pediatrics, Palo Alto, CA, USA

    Steven R. Alexander

  3. Division of Pediatric Nephrology, Center for Pediatrics and Adolescent Medicine, University of Heidelberg, Heidelberg, Germany

    Franz Schaefer

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Shroff, R., Preka, E., Ranchin, B. (2021). Haemodiafiltration: Principles, Technique, and Advantages over Conventional Haemodialysis. In: Warady, B.A., Alexander, S.R., Schaefer, F. (eds) Pediatric Dialysis. Springer, Cham. https://doi.org/10.1007/978-3-030-66861-7_21

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