Is hemodiafiltration the technical solution to chronic inflammation affecting hemodialysis patients?  Antonio Santoro, Elena Mancini  Kidney International  Volume 86, Issue 2, Pages 235-237 (August 2014) DOI: 10.1038/ki.2014.81 Copyright © 2014 International Society of Nephrology Terms and Conditions

Figure 1 Elements for the realization of a low-inflammatory-impact dialysis treatment. Because of the multifactorial nature of inflammation in the chronic hemodialysis patient, an approach on several fronts should be implemented: on the one hand, the elimination of the factors inducing an inflammatory response, and on the other, the direct removal of the inflammatory mediators. Among the former, a high-quality water treatment system, the exclusive use of ultrapure dialysis fluids, and the avoidance of acetate in dialysate, as well as the use of highly biocompatible materials, are the main steps. Among the latter, apart from the mandatory use of high-flux membranes, adsorptive membrane, as well as the direct adsorption of inflammatory mediators on the sorbent cartridge, to arrive at the high-volume convection associated or not to diffusion are the different possible options. Kidney International 2014 86, 235-237DOI: (10.1038/ki.2014.81) Copyright © 2014 International Society of Nephrology Terms and Conditions