Ultrafiltration without dialysis for removal of fluid and solutes in uremia

A review is presented of the use of sequential ultrafiltration and dialysis to facilitate asymptomatic fluid removal in dialysis patiens, and the use of ultrafiltration as a method to remove uremic compounds. In sequential ultrafiltration and dialysis, the two physical principles in hemodialysis are separated in time. Hypotension and other side-effects which may be encountered when the two procedures take place simultaneously are eliminated or minimized by sequential treatment. Hemofiltration is an entirely new form of treatment, which mimics the performance of the human kidney better than hemodialysis. The blood is purified by ultrafiltration and fluid replacement either before or after the ultrafilter device. Preserved well-being or improvement in clinical condition have been reported after prolonged treatment with hemofiltration in spite of relatively inefficient elimination of small molecules as urea and creatinine. The most consistent beneficial effect of hemofiltration appears to be better blood pressure control in severely hypertensive patients than with conventional hemodialysis.