Successful Practice Transitioning Between Hemodialysis and Hemodiafiltration in Outpatient Units: Ten Key Issues for Physicians to Remember

Artif Organs. 2018 Sep;42(9):925-932. doi: 10.1111/aor.13135. Epub 2018 Apr 22.

Abstract

Hemodiafiltration (HDF) during chronic renal replacement therapy (RRT) is a relatively new practice phenomenon, emerging over the last two decades. While the technological platforms utilized during chronic RRT are in many cases similar or effectively identical to conventional hemodialysis (HD), significant differences may emerge in daily practice. Several authors of this review moved practice site between the United States and the European Union and transitioned from an HD-based practice to predominantly HDF-practicing networks. In doing so, we became keenly aware of the potential pitfalls nephrologists may be facing during such transitions. This brief review is intended to provide a succinct overview of several practical concerns and complications nephrologists may encounter in daily practice of end-stage renal disease care, including but not limited to management of electrolytes, renal anemia and treatment goals and settings during HDF.

Keywords: -Bicarbonate; -Complication; -Convective volume; -End-stage renal disease; -Hemofiltration; -Hemoglobin; -Hypocalcemia; -Replacement fluid; -Symptoms; Anticoagulation.

Publication types

  • Review

MeSH terms

  • Hemodiafiltration / methods*
  • Humans
  • Kidney Failure, Chronic / therapy*
  • Outpatients
  • Renal Dialysis / methods*