Critical Appraisal of Haemofiltration and Ultra-Filtration. The Development of Ultra-Short Dialysis: Preliminary Results

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Abstract
The clinical experience obtained with 2 hours every other day recirculation dialysis, using 20-40 liters of dialysate, without sorbents, and standard cuprophane dialyzers of 1.0-1.5 sq.mt. is reported. So far, over 350 treatments in 8 patients have been performed. After 2 hours of treatment the removal of urea, creatinine, phosphate and uric acid, is similar to that obtained by 4-6 hours of haemofiltration. The alkalinazation of the patient through direct venous infusion of bicarbonate, makes predialysis acid-base significantly better than in standard haemodialysis and haemofiltration. Asymptomatic correction of severe fluid overload is easily obtained like in isolated ultrafiltration. The role of osmolality and vasopressors are discussed. A dry weight below the value obtained by previous dialysis treatment is achieved, and volume dependent hypertensions as in haemofiltration are corrected after 2-8 weeks. As an additional advantage, this method offers a highly semplified technical approach and a further reduction of the dialysis time.