[Depurative efficiency of intermediate and large molecules with different hemodialysis modalities]

An accumulation of uremic toxins occurs in renal failure, interfering with different biological functions. Low-flux hemodialysis only clears solutes with a molecular weight lower than 5000 Da. High-flux hemodialysis improves this clearance, being limited from 15,000 Da up. Hemodiafiltration techniques, mid-dilutional, post-dilutional or both, with high reinfusion volumes, are the most efficacious cleaning either large, middle or small uremic toxins. Protein-bound small-size mole cules are not properly removed by any technique. Research in technology and new therapeutic schemes are still needed in order to achieve more physiological depuration methods with better future results.