Chronic maintenance hemodialysis: making sense of the terminology

During the early decades, the hemodialysis (HD) terminology for modality, technique and function altered little as the widely accepted regime of thrice-weekly, 4-hourly dialysis varied little. In the last decade, however, a wide range of new options have emerged in all facets of HD therapy. This has led to a sudden expansion in terminology, some duplicating, some contradictory, some superfluous. The definitions used in 1 geographical region may mean something entirely different elsewhere, increasing cross-continental misunderstanding and misinterpretation and raising the often-asked question: "What exactly did the authors mean by that?" Although clearly the definitions used in this paper are also only the authors' opinion, we have sought to explore the use and sometimes confusing application of many commonly used terms, and we propose a number of possible deletions. Finally, we offer a descriptive data set that we believe should be used for all HD-related papers. Our conclusions will not always be welcomed--particularly by those who use terms we have rejected. Despite this, we believe it pertinent to fully review the dialysis terminology we use. Primarily, we hope to stimulate debate about which terms should be globally adopted and what those terms should mean when used. Although not all will agree with our conclusions, we hope this paper may provide a framework for a more streamlined, efficient, and globally acceptable nomenclature.