Foreword

Preface

Chapter 1 | Fresenius Medical Care & Hemodiafiltration

1.1 | A brief history

1.2 | Educational initiatives

Chapter 2 | From Conventional HD to High-Volume Hemodiafiltration

2.1 | Introduction

2.2 | Conventional hemodialysis

2.3 | Hemofiltration (Diafiltration)

2.4 | Hemodiafiltration

2.5 | Online hemodiafiltration modalities

2.5a Post-dilution HDF

2.5b Pre-dilution HDF

2.5c Mixed dilution HDF

2.5d Mid-dilution HDF

Chapter 3 | Filtration Fraction

Chapter 4 | Hemodiafiltration and Solute Clearances

Chapter 5 | Dialysate and Substitution Fluid Quality in Hemodiafiltration

Chapter 6 | Clinical Evidence Supporting the Benefits of hemodiafiltration

6.1 | Short-term intermediate outcomes

6.1.1  Enhanced toxin clearance

6.1.2 Improved hemodynamic stability

6.1.3 Reduced sudden death risk

6.1.4 Reduced inflammation and oxidative stress

6.1.5 Better anemia management

6.1.6 Residual kidney function protection

6.1.7 Reduced incidence of intradialytic cramps

6.1.8 Reduced skin hyperpigmentation

6.2 | Middle-term intermediate outcomes

6.2.1  Reduced risk of amyloidosis and joint pain

6.2.2  Improved nutritional status

6.2.3  Reduced infection risk

6.2.4  Cardiovascular benefits

6.2.5  Neurological symptoms

6.2.5a Peripheral neuropathy

6.2.5b Cognitive function

6.2.6  Improved quality of life

6.3 | Long-term and hard outcomes

6.3.1 Lower all-cause and cardiovascular mortality

6.3.2 Dose-response relationship

Chapter 7 | High-Volume Hemodiafiltration: Health Economics and Sustainability

Chapter 8 | Practical Implementation and Prescription
Post-Dilution HVHDF

8.1 |  Vascular Access

8.2 | Treatment Prescription

8.2.A Blood Flow

8.2.A1 Needle size, Catheter Lumen

8.2.A2 Extracorporeal pressure regimen

8.2.A3 How to achieve high substitution volume

8.2.A4 Workflow: How to achieve the highest blood flow rate

8.2.B Dialysis treatment time

8.2.C Prescription of anticoagulants

8.2.D Prescription of dialysate flow rate

8.2.E Prescription of dialysate and substitution fluid electrolytes

8.2.E1 Prescription of dialysate and substitution fluid bicarbonate

8.2.E2 Prescription of dialysate and substitution fluid potassium

8.2.E3 Prescription of dialysate and substitution fluid sodium

8.2.E4 Prescription of dialysate and substitution fluid calcium

8.2.F Prescription of dialysate and substitution fluid glucose

8.2.G Prescription of Hemodialyzer

8.3 | Dialysis procedures in stable incident patients starting HDF

8.4 | Dialysis procedures in prevalent patients starting HDF

Chapter 9 | Strategy to prioritize patient selection for the implementation of HVHDF

9.1 |  Eligibility criteria

9.2 | Prioritization Based on Clinical Benefit

9.3 |  Implementation Considerations

Chapter 10 | Medication & Hemodiafiltration

10.1 | Introduction

10.2 | Drug-Related Characteristics

10.3 | Patient characteristics

10.4 | Mechanisms of Drug Clearance in HD vs. HDF

10.5 | Anti-infective agents

10.6 | Vitamins

10.7 | Anticoagulants

10.8 | Antiepileptic Drugs

10.9 | Other Medications

Chapter 11 | Frequent Questions & Answers

11.1 | Patient Eligibility

11.2 | Prescription / Practical Implementation

11.3 | Clinical Outcomes

11.4 | Dialysis Water, Dialysate, and Substitution Fluid

11.5 | Technical

11.6 | Safety and Adverse Events

Chapter 12 | The 5008X CAREsystem

12.1 | AutoFlow™

12.2| AutoSub plus

12.3 | Protocols for Transitioning from HD to HDF Therapy

12.4 | Preparation

12.5 | Treatment

12.6 | Reinfusion

12.7 | Indication for use

Chapter 13 | FX CorAL Dialyzer

References

Authors