This book gives a complete description of online hemodiafiltration, in five sections. It is unique in the systematic and complete way in which hemodiafiltration is described. Each chapter is completed by a point-to-point summary of essential information, in a separate text box. Part of the book is dedicated to the theoretical background of convective clearance. In this part, safety issues and quality control is reviewed (especially on the quality of water for dialysis and substitution fluid), as well as equipment (both dialyzers and machines) with which this treatment can be performed. As recently the results of several randomized controlled trials were available, the effect of hemodiafiltration on hard clinical end points (mortality and morbidity) is discussed in detail. This has not been done before, as the most recent book/journal on hemodiafiltration was published in 2011, before the results of the 3 randomized controlled trials were published.
Furthermore, the methodological quality of the trials is discussed by an expert, in order to help the readers in their judgment of the trials Part of the book concentrates on the effect of the treatment on several biomarkers and uremic toxins. Several clinically relevant issues is discussed separately, such as the prescription of anticoagulation during the treatment, drug prescription and clearance for patients treated with hemodiafiltration, and hemodynamic stability. Finally, a practical guide on how to perform the treatment is provided. In this unique section, seemingly simple but important details of hemodiafiltration-treatment is discussed, such as the importance of needle size for blood flow rates, the difference between filtration fraction and substitution ratio, the different targets that can be set and how to reach them. As most literature is mainly focused on theoretical issues, this unique feature really will help the field to perform hemodiafiltration, and answer practical questions.
Chapter 1 General introduction.- PART I: TECHNICAL ASPECTS.- Chapter 2 Convective techniques.- Chapter 3 Water treatment and safety requirements.- Chapter 4 Description of hemodiafiltration.- Chapter 5 Dialyzers for hemodiafiltration.- PART II: EFFECTS OF HEMODIAFILTRATION ON VARIOUS BIOMARKERS.- Chapter 6 Effects on electrolytes and mineral metabolism.- Chapter 7 Effects on anemia control.- Chapter 8 Effects on inflammation and oxidative stress.- Chapter 9 Effects on the removal of uremic toxins.- Chapter 10 Effects on platelets and coagulation.- PART III: CLINICAL ASPECTS OF HEMODIAFILTRATION.- Chapter 11 Clinical trials on online postdilution hemodiafiltration.- Chapter 12 Cardiovascular effects.- Chapter 13 Hemodynamic stability.- Chapter 14 Nutrition in convective treatments.- Chapter 15 Why is high volume hemodiafiltration associated with improved survival?.- Chapter 16 Hemodiafiltration in children.- Chapter 17 Intensified hemodiafiltration schemes.- Chapter 18 Potential disadvantages of hemodiafiltration.- PART IV: PRACTICAL ISSUES.- Chapter 19 Practical guide to performing high volume hemodiafiltration.- Chapter 20 Medication and hemodiafiltration.- PART V: SUMMARY AND CONCLUSIONS.- Chapter 21 Current status of hemodiafiltration.