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    Area of Science:

    • Nephrology
    • Biomedical Engineering

    Background:

    • Hemodiafiltration (HDF) is a preferred renal replacement therapy.
    • High convective flux in HDF correlates with improved clinical outcomes.
    • Technical limitations like increased transmembrane pressure (TMP) can hinder effective HDF.

    Purpose of the Study:

    • To introduce automated software solutions for overcoming technical barriers in HDF.
    • To enhance the delivery of adequate convective doses during HDF therapy.

    Main Methods:

    • Development of 'predilution on demand' software: automatic hemodilution via dialysate diversion.
    • Implementation of 'backflush on demand' software: TMP-triggered dialysate infusion to clear membrane pores.
    • Integration of these solutions into dialysis machine software for automated operation.

    Main Results:

    • Predilution on demand rapidly restores acceptable parameters and mitigates pressure increases.
    • Backflush on demand significantly improves membrane permeability by detaching protein layers.
    • Both methods effectively overcome technical barriers, enabling higher convective doses.

    Conclusions:

    • Automated predilution and backflush on demand are effective strategies to overcome HDF technical challenges.
    • These technological advancements facilitate wider adoption of HDF and ensure adequate convective therapy.
    • Software-driven solutions enhance HDF efficacy and patient treatment quality.