Optimizing haemodiafiltration: tools, strategy and remaining questions

Abstract

Haemodiafiltration (HDF) is considered the best dialysis therapy currently available in terms of optimal removal of both small and middle molecules. This is obtained by combining diffusive and convective clearance. The efficacy of diffusive transport is usually quantified and monitored by the assessment of small molecule clearance. For this purpose, urea clearance expressed as Kt/Vurea has been widely accepted and used as a parameter for dialysis adequacy. In contrast, it is currently unclear how the efficacy of convective transport should be quantified and monitored.