Author/Editor		Buturović-Ponikvar, J; Ponikvar, R
Title		On-line hemofiltration - our experiences
Type		članek
Source		In: Buturović-Ponikvar J, Bren AF, editors. Zbornik 2. slovenski nefrološki kongres z mednarodno udeležbo ob 30. letnici dialize in transplantacije ledvic v Sloveniji; 2000 sep 27-30; Brdo pri Kranju. Ljubljana: Klinični center, Klinični oddelek za nefrologijo,
Publication year		2000
Volume		str. 285-90
Language		eng
Abstract		Intermittent hemofiltration has been used at our Department as a mode of chronic renal replacement therapy since 1978. During 80-ies replacement fluid with lactate as a buffer and postdilutional mode of fluid exchange were used. The procedure was optimal for small patients with good vascular access enabling high blood flow. In 1985. "in-line" or "on-line" production of substitution fluid from acetate concentrate and purified water became available, enabling higher fluid volumes to be exchanged. The volume of fluid exchange was limited by the rate of acetate metabolism. The major limitations of chronic intermittent hemofiltration at that time were high price, unsatisfactory clearance of substances of low molecular weight, need for high blood flow and nonphysiologic buffer. On line hemofiltration, introduced in 1995 at our center using Gambro AK-100 Ultra hemofiltration monitors, seemed to eliminate the majority of these limitations. Besides, the usual indication for tranferring the patients from "ordinary" bicarbonate hemodialysis to hemofiltration such as cardiovascular instability, hypotension, bad dialysis tolerance, we tried hemofiltration to improve difficult-to-treat hypertension in some of our patients. Three chronic dialysis patients, 1 female and 2 males, aged 37 to 56 years, being dialysed from 4 to 8 years, were transferred from bicarbonate hemodialysis to predilutional on-line hemofiltration because of difficult to treat hypertension with the pattern of increase of blood pressure during hemodialysis. Hypertension was present despite multiple anti hypertensive medication and did not improve with dry body weight reduction. It was accompanied by headache and bad well being. The original disease was chronic glomerulonephritis in all patients, in two of them IgA glomerulonephritis. All of them had native kidneys in situ. (Abstract truncated at 2000 characters.)
Descriptors		HEMOFILTRATION SLOVENIA