TY - CHAP
T1 - Haemodiafiltration
T2 - Principles, technique, and advantages over conventional haemodialysis
AU - Shroff, Rukshana
AU - Preka, Evgenia
AU - Ranchin, Bruno
PY - 2021/5/1
Y1 - 2021/5/1
N2 - 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.
AB - 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.
UR - https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=85150975977&origin=inward
UR - https://www.ncbi.nlm.nih.gov/pubmed/36908764
U2 - https://doi.org/10.1007/978-3-030-66861-7_21
DO - https://doi.org/10.1007/978-3-030-66861-7_21
M3 - Chapter
C2 - 36908764
SN - 9783030668600
T3 - Pediatric Dialysis: Third Edition
SP - 359
EP - 378
BT - Pediatric Dialysis: Third Edition
PB - Springer International Publishing
ER -