Replacement of Excretory Kidney Function by High-Efficiency Hemodiafiltration (HDF) with a Peptide-Permeable Membrane
Despite considerable progress in dialysis technology in the last decade clinical progress in chronic dialysis patients was absent or neglectable. The National Cooperative Dialysis Study reveilled that morbidity in pts on MHD increased when removal of small uremic solutes was inadequate1. The lower limit for dialysis adequacy, as measured by urea kinetics, was a clearance times time product divided by urea distribution volume (Kt/V), which was 0.8 or lower. Thus, morbidity appears to be interrelated to a definable degree of urea removal. On the other hand, such a relationship cannot be demonstrated when solely an improved removal of “middle molecules” (index: Vit. B12) was obtained2.
KeywordsUremic Toxin Dialysis Adequacy Chronic Dialysis Patient Middle Molecule Urea Removal
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- 1.T. F. Parker, N. M. Laird, and E. G. Lowry, Comparison of the study groups in the National Cooperative Dialysis Study and a description of morbidity, mortality and patient withdrawl, Kidney Int. 23, Suppl. 13, 1–122 (1983).Google Scholar
- 2.F. Gotch, Advances in nephrology and dialysis, 1st Satellite Congress of the EDTA-ERA Parma, September 26th, 1986.Google Scholar