Clinical application of On line High flux HDF

Abstract

In various blood depurative therapy available today, High flux HDF (hard HDF) with more than 10l substitution fluid is one of the best method for the great removal of uremic toxin (small, middle and large molecular weight solute) with vascular stability in the shortest possible time. The present problem of hard HDF was the cost of large volume of sterile bicarbonate substitution fluid and the need of special equipment for balancing infusate and ultrafiltrate. For the production of large volume of bicarbonate substitution fluid, bicarbonate dialysate passing through reverse osmosis and two PMMA ultrafiltrater was supplied for substitution fluid, which include less than 1pg/ml of endotoxin (chromogenic substrate method). Using double pump as an equolizer, the volume of infusate and ultrafiltrate was volume-balanced. For the purpose of reducing treatment period and removing low molecular weight protein, convective flow was increased up to 5l/hr. With this system, satisfactory reduction of urea, creatinine and β₂-microglobulin was achieved in the short time. On line Hight flux HDF may be one of the best blood purification method for short time dialysis and elimination of low molecular weight protein.