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[Hemofiltration: present and future]

G M Bosticardo, G Triolo, B Basolo

    Archivio Per Le Scienze Mediche
    |January 1, 1981
    PubMed
    Summary
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    Hemofiltration offers improved patient well-being and better blood pressure control compared to conventional hemodialysis. This renal replacement therapy may benefit patients with dialysis intolerance, hypertension, and dyslipidemia, potentially reducing treatment duration.

    Area of Science:

    • Nephrology
    • Renal Replacement Therapy
    • Critical Care Medicine

    Background:

    • Conventional hemodialysis can lead to complications like intradialytic hypotension, nausea, and cramps.
    • Patients with severe arterial hypertension and dyslipidemia often face challenges with standard hemodialysis.
    • Alternative extracorporeal therapies are needed to improve patient tolerance and outcomes.

    Purpose of the Study:

    • To evaluate the efficacy and safety of hemofiltration in patients intolerant to hemodialysis.
    • To assess hemofiltration's impact on blood pressure control in hypertensive patients.
    • To analyze metabolic, electrolyte, and acid-base balance changes using bicarbonate in replacement fluid.

    Main Methods:

    • Performed 4,000 hemofiltration treatments in 22 patients.

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  • Included patients with low tolerance to conventional hemodialysis (20 cases) and severe hypertension (2 cases).
  • Utilized bicarbonate in the replacement fluid and monitored key physiological parameters.

    • Main Results:

    • Hemofiltration showed a lower incidence of intradialytic collapses, vomiting, and cramps compared to hemodialysis.
    • Patients reported improved interdialytic well-being.
    • Hypertensive patients experienced better arterial pressure control, allowing for reduced pharmacotherapy.

    Conclusions:

    • Hemofiltration demonstrates advantages for patients with poor tolerance to conventional dialysis, severe hypertension, and dyslipidemia.
    • The potential to shorten treatment duration to 3 hours supports wider application of hemofiltration.
    • Bicarbonate-based replacement fluid appears compatible with hemofiltration, maintaining favorable metabolic and electrolyte balance.