Kawanishi / Yamashita Hemodiafiltration - A New Era

1. Auflage 2010
ISBN: 978-3-8055-9561-2
Verlag: S. Karger
Format: PDF
Kopierschutz: Adobe DRM (»Systemvoraussetzungen)

E-Book, Englisch, Band 168, 228 Seiten

Reihe: Contributions to Nephrology

Hemodiafiltration (HDF) for the treatment of end-stage renal disease patients is predominantly performed in European countries and in Japan, with some differences in technique such as rate of blood flow and dialysis fluid delivery systems. The main focus of this book is on the clinical importance of online HDF, the techniques of which have been re-evaluated with the introduction of super high-flux membrane dialyzers. After a brief introduction into the history of HDF, recent advances and clinical experiences of HDF are summarized, including water quality control for dialysis fluid, equipped system for safe use, clinical advantages, and theoretical aspects of HDF. Moreover, at the end of each chapter researchers and scientists discuss problems into which further research is needed. Clinicians and scientists involved in the treatment of end-stage renal disease patients will find this publication an essential source of information. Moreover, it may also serve as a textbook for those who are planning to start HDF in their clinics or who are studying blood purification therapies in medical schools, nursing schools and even in engineering schools related to medical technologies.

Autoren/Hrsg.

Kawanishi

Kawanishi, H.

Yamashita, A.C.

Yamashita

Weitere Mitwirkende

Ronco

Fachgebiete

• Technische Wissenschaften Sonstige Technologien | Angewandte Technik Medizintechnik, Biomedizintechnik
• Medizin | Veterinärmedizin Medizin | Public Health | Pharmazie | Zahnmedizin Klinische und Innere Medizin Nephrologie
• Medizin | Veterinärmedizin Medizin | Public Health | Pharmazie | Zahnmedizin Medizin, Gesundheitswesen Medizintechnik, Biomedizintechnik, Medizinische Werkstoffe

Inhaltsverzeichnis

1;Cover;1
2;Contents;6
3;Preface;9
4;History and Evolution of Hemodiafiltration;11
4.1;Dawn of Hemodiafiltration;11
4.1.1;Abstract;11
4.1.2;First 60 Years (1914 – Early 1970s);11
4.1.3;Middle Molecule Hypothesis and HF;12
4.1.4;Development of HDF;12
4.1.5;The Current Status of HDF in Japan;13
4.1.6;References;14
4.2;Hemodiafiltration – State of the Art;15
4.2.1;Abstract;15
4.2.2;Online Hemodiafiltration;19
4.2.3;References;25
4.3;Hemodiafiltration: Evolution of a Technique towards Better Dialysis Care;29
4.3.1;Abstract;29
4.3.2;Hemodiafiltration: From Origin to Today;29
4.3.3;Techniques of Hemodiafiltration;30
4.3.4;Mechanism of Hemodiafiltration;33
4.3.5;Clinical Outcomes Achieved by HDF;34
4.3.6;Conclusion;36
4.3.7;References;36
5;Clinical Benefits of Hemodiafiltration;38
5.1;Optimal Therapeutic Conditions for Online Hemodiafiltration;38
5.1.1;Abstract;38
5.1.2;Technical Prerequisite and Basic Hygienic Rules for ol-HDF;39
5.1.3;Prerequisite and Technical Options of ol-HDF;41
5.1.4;ol-HDF Prescription in Practice;44
5.1.5;Handling and Microbial Monitoring of ol-HDF;44
5.1.6;Conclusions;45
5.1.7;References;45
5.2;Effect of Hemodiafiltration on Mortality, Inflammation and Quality of Life;49
5.2.1;Abstract;49
5.2.2;Mortality;50
5.2.3;Inflammation;51
5.2.4;Health-Related Quality of Life;55
5.2.5;Treatment Optimization Parameters;57
5.2.6;Conclusion;58
5.2.7;References;58
5.3;How to Prescribe Hemodialysis or Hemodiafiltration in Order to Ameliorate Dialysis-Related Symptoms and Complications;63
5.3.1;Abstract;63
5.3.2;Classical Parameters for Prescribing a Dialysis Modality;64
5.3.3;New Concept for Prescribing a Dialysis Modality;65
5.3.4;Results of the Dialysis Prescription Based on the POD System;66
5.3.5;Rationale of the New Concept for a Dialysis Prescription;67
5.3.6;Practice Pattern for Prescribing Online HDF from a Case Study;71
5.3.7;Conclusion;72
5.3.8;References;72
5.4;Optimizing Home Dialysis: Role of Hemodiafiltration;74
5.4.1;Abstract;74
5.4.2;Benefits of HDF over Low-Flux and High-Flux Hemodialysis;77
5.4.3;Individualizing Choice of Renal Replacement Therapy;79
5.4.4;Providing HDF at Home: Technical Considerations;80
5.4.5;Dialysis Adequacy for Home HDF;83
5.4.6;Equipment Portability;84
5.4.7;Conclusion;84
5.4.8;Acknowledgement;84
5.4.9;References;85
6;Management of Dialysis Fluid and Dialysis System;88
6.1;Quality Management of Dialysis Fluid for Online Convective Therapies;88
6.1.1;Abstract;88
6.1.2;Online Preparation of Substitution Solution for Convective Therapies;89
6.1.3;Components of a Quality Management System;91
6.1.4;References;97
6.2;Biocompatibility of Dialysis Fluid for Online HDF;99
6.2.1;Abstract;99
6.2.2;Purification of Online Preparation;100
6.2.3;Composition of Dialysis and Substitution Fluids;100
6.2.4;Methods;101
6.2.5;Results;103
6.2.6;Discussion;105
6.2.7;Conclusion;106
6.2.8;References;107
6.3;Characteristics of Central Dialysis Fluid Delivery System and Single Patient Dialysis Machine for HDF;109
6.3.1;Abstract;109
6.3.2;Central Dialysis Fluid Delivery System in Japan;109
6.3.3;SPDM in Japan;112
6.3.4;Substitution Fluid for Online HDF with CDDS and SPDM;113
6.3.5;Maintenance of Purification of Dialysis Fluid;114
6.3.6;HD and/or Online HDF Using SPDM by Comprehensive Management;115
6.3.7;Conclusion;116
6.3.8;References;116
6.4;Fully Automated Dialysis System for Online Hemodiafiltration Built into the Central Dialysis Fluid Delivery System;117
6.4.1;Abstract;117
6.4.2;Outline of the Central Dialysis Delivery System;118
6.4.3;FADS with Online HDF;119
6.4.4;Fully Automated Dialysis System;119
6.4.5;Dialysis Fluid Quality Control Standards;121
6.4.6;Fluid Quality Control Method;124
6.4.7;Discussion;125
6.4.8;References;126
7;Uremic Toxins;127
7.1;New Uremic Toxins – Which Solutes Should Be Removed?;127
7.1.1;Abstract;127
7.1.2;Toxicity of Specific Uremic Retention Solutes;128
7.1.3;Removal of Protein-Bound Uremic Solutes and Middle Molecules;133
7.1.4;Interventional Outcome Studies Based on Removal;135
7.1.5;Conclusions;136
7.1.6;References;136
7.2;Beta-2-Microglobulin as a Uremic Toxin: the Japanese Experience;139
7.2.1;Abstract;139
7.2.2;ß2-Microglobulin and Dialysis-Related Amyloidosis;139
7.2.3;Therapeutic Approaches;140
7.2.4;Conclusion;142
7.2.5;References;142
7.3;Markers and Possible Uremic Toxins: Japanese Experiences;144
7.3.1;Abstract;144
7.3.2;Oxidative Stress and AGEs in ESRD;145
7.3.3;Vitamin E-Coated Dialysis Membrane;146
7.3.4;Clinical Effects of Vitamin E-Coated Dialyzer;146
7.3.5;Conclusion;147
7.3.6;References;147
8;Dialysis Membranes for Hemodiafiltration;149
8.1;Biocompatibility of the Dialysis Membrane;149
8.1.1;Abstract;149
8.1.2;Complement Activation;151
8.1.3;Contact Pathway Activation;151
8.1.4;Platelet Activation;151
8.1.5;Monocyte Activation;152
8.1.6;Neutrophil Activation;154
8.1.7;Conclusion;155
8.1.8;References;155
8.2;Choice of Dialyzers for HDF;156
8.2.1;Abstract;156
8.2.2;Materials and Method;158
8.2.3;Results and Discussion;158
8.2.4;Conclusions;161
8.2.5;References;161
8.3;Estimation of Internal Filtration Flow Rate in High-Flux Dialyzers by Doppler Ultrasonography;163
8.3.1;Abstract;163
8.3.2;Materials and Methods;164
8.3.3;Results;167
8.3.4;Discussions;170
8.3.5;Conclusions;170
8.3.6;References;171
9;Clinical Aspects of Hemodiafiltration;172
9.1;Management of Anemia by Convective Treatments;172
9.1.1;Abstract;172
9.1.2;Pathogenesis of Anemia in Chronic Kidney Disease;173
9.1.3;Anemia and Dialysis Dose;174
9.1.4;Convective Treatments;175
9.1.5;Vitamin E-Coated Membranes;176
9.1.6;Online Treatments;176
9.1.7;Conclusions;180
9.1.8;References;180
9.2;Clinical Evaluation Indices for Hemodialysis/Hemodiafiltration in Japan;183
9.2.1;Abstract;183
9.2.2;Historical Review of Chronic HD Therapy in Japan;184
9.2.3;Influence of the Low Prevalence of Renal Transplantation on Chronic HD Therapy in Japan;184
9.2.4;Impacts of High-Flux Membrane Dialyzers on Clinical Indices of HD Patients;185
9.2.5;Impacts of HDF on the Clinical Indices of HD Patients;187
9.2.6;References;188
9.3;Effect of Large-Size Dialysis Membrane and Hemofiltration/Hemodiafiltration Methods on Long-Term Dialysis Patients;189
9.3.1;Abstract;189
9.3.2;Development of Protein-Permeable Dialysis Membrane;190
9.3.3;Removal of Uremic Substances and Loss of Albumin in Low MW Protein Region;191
9.3.4;Clinical Efficiency;192
9.3.5;Conclusion;195
9.3.6;References;197
9.4;Who Needs Acetate-Free Biofiltration?;198
9.4.1;Abstract;198
9.4.2;Background;198
9.4.3;Concept of Acetate-Free Biofiltration;198
9.4.4;Indication for AFB;199
9.4.5;AFHD vs. AFB;200
9.4.6;Conclusion;202
9.4.7;References;203
9.5;Improvement of Autonomic Nervous Regulation by Blood Purification Therapy Using Acetate-Free Dialysis Fluid – Clinical Evaluation by Laser Doppler Flowmetry;205
9.5.1;Abstract;205
9.5.2;Evaluation of Autonomic Function by NICOMM;206
9.5.3;Stability Index of Tissue Blood Flow in the Head;208
9.5.4;Evaluation of Blood Purification Modalities with the Head SI;209
9.5.5;Conclusions;212
9.5.6;References;213
9.6;Preservation of Residual Renal Function with HDF;214
9.6.1;Abstract;214
9.6.2;Background;214
9.6.3;Study 1;215
9.6.4;Study 2;216
9.6.5;Study 3;217
9.6.6;Discussion;220
9.6.7;Acknowledgments;221
9.6.8;References;221
10;Author Index;223
11;Subject Index;224