Hemodiafiltration Theory, Technology and Clinical Practice
This book provides a complete description of online hemodiafiltration (HDF) in five sections. Sections cover topics such as technical and essential aspects of convective techniques, equipment, the effects of HDF treatment on various biomarkers, results of
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Hemodiafiltration Theory, Technology and Clinical Practice
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Hemodiafiltration
Menso J. Nubé • Muriel P.C. Grooteman Peter J. Blankestijn Editors
Hemodiafiltration Theory, Technology and Clinical Practice
Editors Menso J. Nubé VU Medical Center Amsterdam The Netherlands
Peter J. Blankestijn University Medical Center Utrecht Utrecht The Netherlands
Muriel P.C. Grooteman VU Medical Center Amsterdam The Netherlands
ISBN 978-3-319-23331-4 ISBN 978-3-319-23332-1 DOI 10.1007/978-3-319-23332-1
(eBook)
Library of Congress Control Number: 2015956130 Springer Cham Heidelberg New York Dordrecht London © Springer International Publishing Switzerland 2016 This work is subject to copyright. All rights are reserved by the Publisher, whether the whole or part of the material is concerned, specifically the rights of translation, reprinting, reuse of illustrations, recitation, broadcasting, reproduction on microfilms or in any other physical way, and transmission or information storage and retrieval, electronic adaptation, computer software, or by similar or dissimilar methodology now known or hereafter developed. The use of general descriptive names, registered names, trademarks, service marks, etc. in this publication does not imply, even in the absence of a specific statement, that such names are exempt from the relevant protective laws and regulations and therefore free for general use. The publisher, the authors and the editors are safe to assume that the advice and information in this book are believed to be true and accurate at the date of publication. Neither the publisher nor the authors or the editors give a warranty, express or implied, with respect to the material contained herein or for any errors or omissions that may have been made. Printed on acid-free paper Springer International Publishing AG Switzerland is part of Springer Science+Business Media (www. springer.com)
Preface
Hemodialysis (HD) has become the standard renal replacement therapy for patients with end-stage kidney disease, with more than two million patients now treated worldwide. However, despite prominent technological improvements over the last decades, the overall 5-year survival for HD patients remains less than that for some of the more common solid organ malignancies, such as colon cancer. HD is an effective treatment for removing small water-soluble solutes, such as urea by diffusion, but simply increasing urea clearance has not been shown to improve survival. Standard HD with low-flux membranes is not effective in clearing larger middle molecules, such as beta-2-microglobulin, which then accumulates over time, leading to dialysis amyloid deposition. To improve the clearance of these larger uremic toxins, large pore dialyzer membranes (high-flux) were developed, but trials comparing high-flux HD with low-flux HD did not show improved patient survival. The clearance of these larger molecules is much more efficient using convection rather than diffusion, and this led to the introduction of hemodiafiltration (HDF) which provides bot
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