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Intensified Hemodiafiltration

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Abstract

Mortality in patients under a conventional dialysis regimen of three 4-h sessions per week is four times higher than in the general population older than 65 years and new therapeutic regimens are required to improve patient survival. The thrice-weekly frequency of hemodialysis (HD), established the 1960s, has mainly been accepted and maintained since then for logistic, pragmatic and economic reasons. However, longer and more frequent dialysis sessions have produced excellent survival and clinical advantages. The results of the Tassin experience of long, slow-flow HD were first reported 30 years ago and showed excellent fluid and blood pressure control with the highest survival rates achieved at that time. Since then, multiple publications reported on the superiority of long-duration HD over conventional therapy. On-line postdilution hemodiafiltration (OL-HDF) offers an optimal form of extracorporeal treatment for patients with end-stage kidney disease. This technique, which combines diffusion with a considerable amount of convection, provides the highest clearances per unit of surface area for small, medium and large molecules. In this chapter we describe our experience with OL-HDF in two extended dialysis schemes: short daily OL-HDF and nocturnal, every-other-day, OL-HDF.

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Author information

Authors and Affiliations

  1. Department of Nephrology, Hospital Clínic, Villarroel, 170, Barcelona, Catalonia, 08036, Spain

    Francisco Maduell MD, PhD, Raquel Ojeda MD & Marta Arias-Guillén MD

Authors
  1. Francisco Maduell MD, PhD
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  2. Raquel Ojeda MD
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  3. Marta Arias-Guillén MD
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Corresponding author

Correspondence to Francisco Maduell MD, PhD .

Editor information

Editors and Affiliations

  1. Department of Nephrology, VU University Medical Centre, Amsterdam, The Netherlands

    Menso J. Nubé

  2. Department of Nephrology, VU University Medical Center, Amsterdam, The Netherlands

    Muriel P.C. Grooteman

  3. Department of Nephrology, University Medical Center Utrecht, Utrecht, The Netherlands

    Peter J. Blankestijn

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© 2016 Springer International Publishing Switzerland

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Maduell, F., Ojeda, R., Arias-Guillén, M. (2016). Intensified Hemodiafiltration. In: Nubé, M., Grooteman, M., Blankestijn, P. (eds) Hemodiafiltration. Springer, Cham. https://doi.org/10.1007/978-3-319-23332-1_21

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  • DOI: https://doi.org/10.1007/978-3-319-23332-1_21

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-23331-4

  • Online ISBN: 978-3-319-23332-1

  • eBook Packages: MedicineMedicine (R0)

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