Altieri, Paolo and Sorba, Gianbattista and Bolasco, Piergiorgio and Ledebo, Ingrid and Bolasco, Ferruccio and Ganadu, Marino and Cadinu, Franco and Ferrara, Rocco and Cabiddu, Gianfranca (2001) On-line hemofiltration in chronic renal failure: advantages and limits. Saudi Journal of Kidney Diseases and Transplantation, Vol. 12 (3), p. 387-397. ISSN 1319-2442. Article.
The actual dialysis therapy offers a notable long-term survival and rehabilitation, but it is still far from normalizing the patient's quality of life as well as mortality and morbidity. The most widely used dialysis therapy is an almost exclusive diffusive treatment performed with low-flux cellulose membranes with a dialysis dose targeted to a urea Kt/V of 1.2 or higher. The convective treatments, which use highflux membranes, offer proven biological superiority over diffusive treatments, which are performed with bio-incompatible, lowflux membranes. Retrospective epidemiological studies have documented a reduction of morbidity and mortality with the use of high-flux membranes, but the results of the prospective studies comparing low-flux with high-flux treatments are still conflicting. Cardiovascular instability during treatment sessions is a potential cause of morbidity and mortality for patients on dialysis treatment. Hemofiltration (HF) is a pure convective treatment and offers the best tolerance to fluid subtraction in hemodynamically unstable patients. Because of its limitation in removing urea as well as high costs, HF treatment is restricted to few high risk unstable patients. The modern predilution HF, performed with ultrapure online prepared solutions, overcomes, at least partially, the above limitation, but there is scarcity of data evaluating its long-term efficacy in stable patients.
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