On-line Hemodiafiltration

The survival of patients on hemodialysis is very poor when compared to kidney transplantation. Several attempts have been made to improve the survival of dialysis patients. Some such attempts are more frequent dialysis, more prolonged dialysis, use of high flux dialyzers, use of ‘ultrapure’ dialysate, and better electrolyte and mineral metabolism. Hemodiafiltration is one such measure, where both diffusive and convective methods of toxincan be removed. They are exploited with a view of removing both small molecular weight and larger molecular weight toxins from the body.

How is it different from Conventional Dialysis?

In this procedure, the toxins are removed using principles of diffusion and convection. It offers a better survival to patients as compared to conventional dialysis- that involves only the principle of diffusion.

The most important requirement of hemodiafiltration is the availability of ultrapure (injection quality) water. It has been seen that many patients tolerate hemodiafiltration much better than hemodialysis with fewer hypertension episodes. Dr. Dinesh Khullar mentions a few benefits of this procedure:.

• Clearance of middle molecular toxins like beta 2 microglobulin, phosphorous, inflammatory cytokines, resulting in a lesser incidence of complications like dialysis-related amyloidosis.
• Better control of renal bone disease
• Its low pro-inflammatory cytokine levels lead to a decrease in cardiovascular mortality, improved nutrition, decrease itching, and better control of anaemia.