Improvements in technology: a path to safer and more effective hemodialysis

Effective dialysis therapy is now understood to encompass both small and large solute removal, using approaches that minimize intradialytic symptoms and maximize patient safety. Achieving the goal of providing effective dialysis for an expanding population of patients with increasingly complex medical problems at a time of limited resources will require technological innovation. To address this need, the latest generation of ergonomically designed dialysis machines incorporates as standard features the technology required to perform on-line convective therapies to maximize large solute removal, on-line measurement of ionic clearance to monitor small solute removal and real-time data processing to guide the delivery of therapy. In addition, these machines feature feedback control systems that may help reduce the unpleasant side effects associated with fluid removal during hemodialysis. These technological innovations offer therapeutic versatility while, at the same time, reducing the burden on patient care personnel, and are likely to make an important contribution to delivering safer and more effective dialysis therapy.