Haemodiafiltration combines elements of diffusion and convection in a single treatment modality to provide solute removal over a wide range of molecular weights. Theoretically, it represents the best available form of renal replacement therapy but uptake of the technique has been slow. This pattern may change, given the growing acceptance of the potential benefits of the technique, the maturing technology including cost-efficient online production of substitution fluid, and the demonstration of the long-term safety of the technique. Long-term clinical outcome data are awaited.

Shinzato T, Sezaki R, Usuda M, Maeda K, Ohbayashi S, Toyota T: Infusion-free hemodiafiltration: simultaneous hemofiltration and dialysis with no need for infusion fluid. Artif Organs 1982;6:453–456.
von Albertini B, Barlee V, Bosch JP: Double high-flux haemodiafiltration: A means to enhance efficiency and efficacy of dialysis. J Am Soc Nephrol 1996;7:1423.
Ronco C, Brendolan A, Crepaldi C, Gastaldon F, Levin NW: Flow distribution and cross filtration in hollow fiber hemodialyzers. Contrib Nephrol. Basel, Karger, 2002, pp 120–128.
Marinez de Francisco AL, Ghezzi PM, Brendolan A, Fiorini F, La Greca G, Ronco C, Arias M, Gervasio R, Tetta C: Hemodiafiltration with online regeneration of the ultrafiltrate. Kidney Int Suppl 2000;76:S66–S71.
Henderson LW, Beans E: Successful production of sterile pyrogen-free electrolyte solution by ultrafiltration. Kidney Int 1978;14:522–525.
Kleophas W, Haastert B, Backus G, Hilgers P, Westhoff A, van Endert G: Long-term experience with an ultrapure individual dialysis fluid with a batch type machine. Nephrol Dial Transplant 1998;13:3118–3125.
Vaslaki L, Karatson A, Voros P, Major L, Petho F, Ladanyi E, Weber C, Mitteregger R, Falkenhagen D: Can sterile and pyrogen-free on-line substitution fluid be routinely delivered? A multicentric study on the microbiological safety of on-line haemodiafiltration. Nephrol Dial Transplant 2000;15(suppl 1):74–78.
Canaud B, Bosc JY, Leray-Moragues H, Stec F, Argiles A, Leblanc M, Mion C: On-line haemodiafiltration. Safety and efficacy in long-term clinical practice. Nephrol Dial Transplant 2000;15(suppl 1):60–67.
Leypoldt JK: Solute fluxes in different treatment modalities. Nephrol Dial Transplant 2000;15(suppl 1):3–9.
Pedrini LA, De C, V, Pagliari B, Sama F: Mixed predilution and postdilution online hemodiafiltration compared with the traditional infusion modes. Kidney Int 2000;58:2155–2165.
Maduell F, Navarro V, Cruz MC, Torregrosa E, Garcia D, Simon V, Ferrero JA: Osteocalcin and myoglobin removal in on-line hemodiafiltration versus low- and high-flux hemodialysis. Am J Kidney Dis 2002;40:582–589.
Lornoy W, Becaus I, Billiouw JM, Sierens L, Van Malderen P, D’Haenens P: On-line haemodiafiltration. Remarkable removal of beta-2-microglobulin: Long-term clinical observations. Nephrol Dial Transplant 2000;15:49–54.
Zehnder C, Gutzwiller JP, Renggli K: Hemodiafiltration – a new treatment option for hyperphosphatemia in hemodialysis patients. Clin Nephrol 1999;52:152–159.
Canaud B, Bosc JY, Leray H, Stec F, Argiles A, Leblanc M, Mion C: On-line haemodiafiltration: State of the art. Nephrol Dial Transplant 1998;13(suppl 5):3–11.
Wizemann V, Lotz C, Techert F, Uthoff S: On-line haemodiafiltration versus low-flux haemodialysis. A prospective randomized study. Nephrol Dial Transplant 2000;15(suppl 1):43–48.
Pickett TM, Cruickshank A, Greenwood RN, Taube D, Davenport A, Farrington K: Membrane flux not biocompatibility determines beta-2-microglobulin levels in hemodialysis patients. Blood Purif 2002;20:161–166.
Baldamus CA, Ernst W, Frei U, Koch KM: Sympathetic and hemodynamic response to volume removal during different forms of renal replacement therapy. Nephron 1982;31:324–332.
Movilli E, Camerini C, Zein H, D’Avolio G, Sandrini M, Strada A, Maiorca R: A prospective comparison of bicarbonate dialysis, hemodiafiltration, and acetate-free biofiltration in the elderly. Am J Kidney Dis 1996;27:541–547.
Locatelli F, Mastrangelo F, Redaelli B, Ronco C, Marcelli D, La Greca G, Orlandini G: Effects of different membranes and dialysis technologies on patient treatment tolerance and nutritional parameters. The Italian Cooperative Dialysis Study Group. Kidney Int 1996;50:1293–1302.
Maggiore Q, Pizzarelli F, Dattolo P, Maggiore U, Cerrai T: Cardiovascular stability during haemodialysis, haemofiltration and haemodiafiltration. Nephrol Dial Transplant 2000;15(suppl 1):68–73.
Bergamo Collaborative Dialysis Study Group: Acute intradialytic well-being: Results of a clinical trial comparing polysulfone with cuprophan. Kidney Int 1991;40:714–719.
van der Sande FM, Kooman JP, Leunissen KM: Blood temperature monitor: a novel tool in the management of dialysis-induced hypotension. Contrib Nephrol. Basel, Karger, 2002, pp 245–253.
Bonforte G, Grillo P, Zerbi S, Surian M: Improvement of anemia in hemodialysis patients treated by hemodiafiltration with high-volume on-line-prepared substitution fluid. Blood Purif 2002;20:357–363.
Chandna SM, Tattersall JE, Nevett G, Tew CJ, O’Sullivan J, Greenwood RN, Farrington K: Low serum vitamin B12 levels in chronic high-flux haemodialysis patients. Nephron 1997;75:259–263.
Morena M, Cristol JP, Bosc JY, Tetta C, Forret G, Leger CL, Delcourt C, Papoz L, Descomps B, Canaud B: Convective and diffusive losses of vitamin C during haemodiafiltration session: A contributive factor to oxidative stress in haemodialysis patients. Nephrol Dial Transplant 2002;17:422–427.
Minutolo R, Bellizzi V, Cioffi M, Iodice C, Giannattasio P, Andreucci M, Terracciano V, Di Iorio BR, Conte G, De Nicola L: Postdialytic rebound of serum phosphorus: pathogenetic and clinical insights. J Am Soc Nephrol 2002;13:1046–1054.
Malberti F, Surian M: Ionised calcium changes and parathyroid hormone secretion in haemodiafiltration in relation to substitution fluid calcium content. Nephrol Dial Transplant 1991;6(suppl 2):104–107.
McKane W, Chandna SM, Tattersall JE, Greenwood RN, Farrington K: Identical decline of residual renal function in high-flux biocompatible hemodialysis and CAPD. Kidney Int 2002;61:256–265.
Mitka M: How to reduce mortality in hemodialysis patients still a puzzle. JAMA 2002;287:2643–2644.
Greenwood, R. N. An incremental high-flux/haemodiafiltration program based on urea kinetic modelling. Semin Dial 1999;12:S71–S75.
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