Improving Solute Clearances by Hemodialysis

The adequacy of hemodialysis is now assessed by measuring the removal of the single-solute urea. The urea clearance provided by contemporary dialysis is a large fraction of the blood flow through the dialyzer and therefore cannot be increased much further. Other solutes however likely contribute mor...

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Bibliographic Details
Published inBlood purification Vol. 51; no. Suppl 1; pp. 20 - 31
Main Authors Lee, Seolhyun, Sirich, Tammy L., Meyer, Timothy W.
Format Journal Article
LanguageEnglish
Published Basel, Switzerland 25.05.2022
Subjects
Review – Advances in CKD 2022
Removal
Urea
Protein-free fraction
Uremic toxins
Solute clearance
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Summary:The adequacy of hemodialysis is now assessed by measuring the removal of the single-solute urea. The urea clearance provided by contemporary dialysis is a large fraction of the blood flow through the dialyzer and therefore cannot be increased much further. Other solutes however likely contribute more than urea to the residual uremic illness suffered by hemodialysis patients. We here review methods which could be employed to increase the clearance of nonurea solutes. We will separately consider the clearances of free low-molecular-mass solutes, free larger solutes, and protein-bound solutes. New clinical studies will be required to test the extent to which increasing the clearance on nonurea solutes with these various characteristics can improve patients' health.
Bibliography:ObjectType-Article-2
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ObjectType-Review-1
ISSN:0253-5068
1421-9735
DOI:10.1159/000524512