Scholarlink

Background <p>Several techniques are available for chronic renal replacement therapy. In addition to conventional hemodialysis, dialysis membranes with a&#xa0;high molecular cut-off (several types, here summarized as high cut-off, HCO) can be used or hemodiafiltration (HDF) can be applied.</p> Research question <p>Which criteria should be used to guide the differential therapy of extracorporeal blood purification? Are procedures with extended elimination characteristics demonstrably beneficial for specific patient groups?</p> Method <p>A&#xa0;selective literature review was carried out, including the current national and international guidelines on renal replacement therapy.</p> Results <p>Conventional hemodialysis is currently the most widely used method, predominantly employing synthetic high-flux (HF) dialyzers. Dialysis membranes with an increased cut-off eliminate molecules in the molecular weight range of 30–50 kD more effectively than HF dialyzers and are therefore particularly suitable for the removal of immunoglobulin light chains, myoglobin or inflammation mediators; however, prospective studies did not prove clinical advantages (for light chains) or only demonstrated improved surrogate parameters (rhabdomyolysis, inflammation). The HDF can be advantageous for selected patients with high volume filtration and may provide a&#xa0;survival benefit. The target group consists of younger, less comorbid patients with high-volume vascular access.</p> Conclusion <p>While hemodialysis remains the standard, selected patients should be treated with HDF. The use of HCO membranes is reserved for specific cases. Whether HCO could be applied as a&#xa0;permanent option equivalent to HDF remains to be investigated.</p>

错误：搜索内容不能为空，请输入英文关键词
错误：关键词超出字数限制，请精简
高级检索

High-flux-Dialyse, Hämodiafiltration, High-cut-off-Dialyse

  • 期刊论文

  • 发表日期：

    2025年7月30日

查看全文
  • Victor Walendy,
  • Matthias Girndt,
  • Silke Markau

摘要

Background

Several techniques are available for chronic renal replacement therapy. In addition to conventional hemodialysis, dialysis membranes with a high molecular cut-off (several types, here summarized as high cut-off, HCO) can be used or hemodiafiltration (HDF) can be applied.

Research question

Which criteria should be used to guide the differential therapy of extracorporeal blood purification? Are procedures with extended elimination characteristics demonstrably beneficial for specific patient groups?

Method

A selective literature review was carried out, including the current national and international guidelines on renal replacement therapy.

Results

Conventional hemodialysis is currently the most widely used method, predominantly employing synthetic high-flux (HF) dialyzers. Dialysis membranes with an increased cut-off eliminate molecules in the molecular weight range of 30–50 kD more effectively than HF dialyzers and are therefore particularly suitable for the removal of immunoglobulin light chains, myoglobin or inflammation mediators; however, prospective studies did not prove clinical advantages (for light chains) or only demonstrated improved surrogate parameters (rhabdomyolysis, inflammation). The HDF can be advantageous for selected patients with high volume filtration and may provide a survival benefit. The target group consists of younger, less comorbid patients with high-volume vascular access.

Conclusion

While hemodialysis remains the standard, selected patients should be treated with HDF. The use of HCO membranes is reserved for specific cases. Whether HCO could be applied as a permanent option equivalent to HDF remains to be investigated.