On-line haemodiafiltration - definiton, effectiveness and safety: document of European Initiative EUDIAL and comments on results of prospectivecontrolled clinical trials
Abstract
There has been an intense discussion on ever-growing use of the on-line haemodialfiltration (HDF), both in our country and Europe-wide, focused namely on importance of substitution fluid volume used. The aim of this article is to provide corresponding wxpert frame for that discussion.
Based on the definition work of the EUDIAL group active in this field under the umbrella of the ERA-EDTA, the tools to assess efficacy of this convective method are outlined. Three recent fundamental publications, which came with the concept of so-called high-volume HDF are analyzed in detail, namely their conclusions regarding ihe impact of substitution volume on morbidity and mortality of treated patientts.
This analysis is complemented by data from a few most recent publications which discuss specific pros and cons of HDF. Stressed is also critical importance of water purity with increasing substitution volumes.