الفهرس 
HemodiafiltrationOnly 14 pages are availabe for public view
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Abstract
Over the last three decades, it has been demonstrated that haemodialysis (HD) is an efficient therapy, capable of supporting the life of more than one million chronic kidney disease stage V (CKD-V) patients worldwide. However, the success story of renal replacement therapy (RRT) is not complete. High morbidity and high mortality rates of CKD-V patients on supportive therapy are still a challenging problem. In addition, it is frustrating for clinicians to observe that, in spite of major technical advances (high-flux membrane, bicarbonate-buffered dialysis fluid, ultrafiltration-controlled machine, bio-compatible material, etc.) and many therapeutic achievements (correction of haematological and metabolic disorders such as anemia by recombinant human erythropoietin (rHu-EPO), hyperlipidaemia, hyperphosphataemia, hyperparathyroidism, etc.), there has been no significant progress in patient survival. The increasing prevalence of dialysis-related pathology, including beta 2-microglobulin (β2m)-amyloidosis, accelerated atherosclerosis, left ventricular hypertrophy, ageing and malnutrition in long-term treated patients, is another sign of the partial failure of RRT (Canaud et al., 2004).
Convective methods mimicking glomeruli filtration of native kidneys are required to enlarge the molecular weight spectrum of solutes removed during the dialysis session, with the intent of maximising toxin removal. Online haemodiafiltration (OHDF) provides several advantages in this context by combining diffusive and enhanced convective clearances. It offers an efficient modality to clear small- and middle-size uremia toxins by using ultrapure dialysis fluid and high-flux synthetic membranes; it offers the most biocompatible dialysis system by providing a virtually unlimited amount of sterile dialysis fluid by cold sterilization filtration; it offers an economical and viable method to achieve high-efficiency haemodiafiltration (HDF) (high fluid volume exchange) therapy; and by keeping the dialysis machine with all in-built technical options (fluid-balancing system, thermal balance, online ionic dialysate monitoring, etc.), it offers the best of the technical options in RRT (Pozzoni et al., 2006).