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      Optimization of the convection volume in online post-dilution haemodiafiltration: practical and technical issues

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          Abstract

          In post-dilution online haemodiafiltration (ol-HDF), a relationship has been demonstrated between the magnitude of the convection volume and survival. However, to achieve high convection volumes (>22 L per session) detailed notion of its determining factors is highly desirable. This manuscript summarizes practical problems and pitfalls that were encountered during the quest for high convection volumes. Specifically, it addresses issues such as type of vascular access, needles, blood flow rate, recirculation, filtration fraction, anticoagulation and dialysers. Finally, five of the main HDF systems in Europe are briefly described as far as HDF prescription and optimization of the convection volume is concerned.

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          EBPG on Vascular Access.

          Jan Tordoir, James Tattersall, Klaus Konner … (2007)
          Article 0 comments Cited 139 times – based on 0 reviews     Review now
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            Beta2-microglobulin.

            Tilman B. Drueke, Ziad Massy (2015)
            Among the uremic toxins in the "middle molecule" range, beta2-microglobulin (beta2-M) is certainly one of the most frequently studied compounds. Its serum level increases with the progression of chronic kidney disease, to reach very high concentrations in patients with end-stage kidney disease. It is the major protein component of dialysis-related amyloidosis, a dramatic complication which results from high extracellular concentration and posttranslational modification of beta2-M and a number of other promoters of amyloid fibril formation and deposition in osteo-articular tissues. Effective removal of beta2-M can be achieved with highly effective hemodialysis and hemodiafiltration techniques but predialysis session serum levels cannot be normalized. The prevalence and severity of beta2-M amyloidosis appear to have decreased in the last 20 years, although its occurrence may simply be delayed.
            Article 0 comments Cited 35 times – based on 0 reviews     Review now
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              Patient- and treatment-related determinants of convective volume in post-dilution haemodiafiltration in clinical practice.

              E. Lars Penne, Neelke van der Weerd, Michiel L. Bots … (2009)
              Large convective volumes are recommended for online haemodiafiltration (HDF) to maximize solute removal. There has been little systematic evaluation of factors that determine convective volumes in routine clinical practice.
              Article 0 comments Cited 31 times – based on 0 reviews     Review now
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                Author and article information

                Journal
                Journal ID (nlm-ta): Clin Kidney J
                Journal ID (iso-abbrev): Clin Kidney J
                Journal ID (publisher-id): ckj
                Journal ID (hwp): ndtplus
                Title: Clinical Kidney Journal
                Publisher: Oxford University Press
                ISSN (Print): 2048-8505
                ISSN (Electronic): 2048-8513
                Publication date (Print): April 2015
                Publication date (Electronic): 16 February 2015
                Publication date PMC-release: 16 February 2015
                Volume: 8
                Issue: 2
                Pages: 191-198
                Affiliations
                [1 ]Department of Nephrology, VU University Medical Center , Amsterdam, The Netherlands
                [2 ]Department of Nephrology, University Medical Center Utrecht , Utrecht, The Netherlands
                [3 ]Department of Nephrology, Centre Hospitalier de l'Université de Montréal, St. Luc Hospital , Montréal, Canada
                [4 ]UCL Centre for Nephrology, Royal Free Hospital , London, UK
                [5 ]Division of Nephrology, Department of Medicine, University of Würzburg , Würzburg, Germany
                [6 ]Institute for Cardiovascular Research VU University Medical Center (ICaR-VU), VU University Medical Center , Amsterdam, The Netherlands
                Author notes
                Correspondence to: Muriel P.C. Grooteman; E-mail: mpc.grooteman@ 123456vumc.nl
                Article
                Publisher ID: sfv003
                DOI: 10.1093/ckj/sfv003
                PMC ID: 4370303
                PubMed ID: 25815176
                SO-VID: 61dc7e36-bc25-4957-bc8d-1242aa7d2601
                Copyright © © The Author 2015. Published by Oxford University Press on behalf of ERA-EDTA.
                License:

                This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License ( http://creativecommons.org/licenses/by-nc/4.0/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is properly cited. For commercial re-use, please contact journals.permissions@oup.com

                History
                Date received : 24 October 2014
                Date accepted : 12 January 2015
                Categories
                Subject: Contents
                Subject: Haemodiafiltration

                ScienceOpen disciplines: Nephrology
                Keywords: convection volume,haemodiafiltration
                Data availability:
                ScienceOpen disciplines: Nephrology
                Keywords: convection volume, haemodiafiltration

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