hemodiafiltraatiota

Hemodiafiltraatio is a renal replacement therapy that combines hemodialysis and hemofiltration. It is used to treat patients with kidney failure, particularly those who experience intradialytic hypotension or are unable to tolerate conventional hemodialysis. This treatment involves the removal of waste products and excess fluid from the blood through both diffusion and convection. The diffusive process, similar to hemodialysis, relies on the concentration gradient across a semipermeable membrane to remove small solutes. The convective process, characteristic of hemofiltration, involves the movement of solutes along with fluid across the membrane, driven by a transmembrane pressure gradient.

In hemodiafiltration, blood is pumped from the patient's body through a dialyzer. During the treatment, a substitution fluid is infused either pre-dilution or post-dilution. Pre-dilution involves adding the substitution fluid to the blood before it enters the dialyzer, while post-dilution adds it after the blood has passed through. This substitution fluid helps to enhance the clearance of larger solutes and maintain hemodynamic stability by replacing the fluid removed during convection. Hemodiafiltration is often performed using online systems, where the substitution fluid is generated from purified dialysate, offering advantages in terms of cost and convenience. The primary goal is to achieve adequate removal of uremic toxins, manage fluid balance, and improve the overall well-being of patients with end-stage renal disease.