Hemodiafiltration also known in short as HDF was introduced by one Mr Henderson in 1967. This is basically a renal replacement technique. It combines convection and diffusion. This could help in removal of solute of different molecular weights. The good thing about this method is that the ultrafiltration or UF amount is much more than the fluid loss that takes place. The hemodiafiltration machine also allows to administer the desired amount of replacement fluid so that the targeted fluid balance is always maintained. The impact of convection to the total solute removal also goes up progressively as the molecular weight also increases.
It is Considered Effective and Safe
There have been quite a few developments as far as membranes, fluids and machines are concerned. This has helped in making HDF technique absolutely safe and effective. This technique also comes with a highly accurate UF volumetric control system that is available in dialysis machines. This helps reduce the risk of fluid balancing errors that often crop up. New technologies have brought in many online methods of preparation of pyrogen-free and sterile solutions. This has made it possible to infuse relatively much larger amounts of fluid. Hence, when all these are taken into account, there are reasons to believe that HDF has become a safe, simple, effective and routine procedure.
What are the Various HDF Techniques?
There are different ways in which hemodiafiltration can be done. The most common is the classic HDF method. This is done by going for an average infusion of 9 litres per session when we are in the post-dilution mode. There is also another form of HDF and this is referred to as acetate free biofiltration. This is even better, though slightly more complicated but it is considered safer because it helps remove even the minutest traces of acetate both from the replacement fluid and also from the dialysate fluid. This could certainly be of great benefit for the hemodynamics of patients who are unstable.
There is another HDF technique and it is referred to as high volume HDF. It uses a minimum of 15 litres of reinfusion per each session. However, there is a cost detriment to it because of the high cost of commercial replacement fluids. In this technique totally pure dialysate is processed through the dialysate line. It is done with the use of multiple filtration steps. This is then used as a replacement fluid. This is considered to be cost effective because it helps to create generous amounts of replacement solutions that are not very expensive and are affordable.
Apart from the above there are also other techniques such as paired filtration dialysis, HDF using mid-dilution technology and last but not the least push and pull HDF. Hence, there are reasons to believe that the technology that combines diffusion and convection is here to stay because of the benefits and conveniences that it offers.
The Final Word
To sum up, though conventional forms of dialysis still continue to be very popular, the obvious advantages and benefits associated with a hemodiafiltration machine cannot be ignored. It is becoming more and more popular amongst thousands of patients and also doctors treating them because of severe or chronic renal problems and renal failure. In the next few years, it may become the most used form of hemodiafiltration.
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