Plasmadialysis as an alternative method to improve degree of the dialysis in patients with chronic renal failure

Abstract

Currently it is clear that adequate degree of dialysis of patients with chronic renal failure not only prolongst heir survival, but also results in reduction of atherosclerosis progression and improves their immunity (infections, malignancies), eventually resulting in reduction of treatment costs [1–5].

Therapy of such patients is multifactorial. Essentially it can be divided into medical treatment (maintenance and forcing residual urine output, using an optimal diet and fluid supply, treating an underlying disease, controlling potential infection foci, treating abnormalities of erythropoiesis, lipid metabolism, calcium-phosphate, etc) and procedural treatment (renal replacement therapy). Improved degree of dialysis in these patients during repeated hemodialyses can be achieved by, among others: increased duration and frequency of dialysis procedures, increased blood flow through the blood channel in the dialyzer to a maximum value, increased flow of the dialyzing fluid, use of dialyzers with large exchange areas, dialysis through two-needle access, alternating hemodialysis and hemodiafiltration procedures [6–12]. However, all these methods are not universally effective, in particular in patient with poor vascular access (with low efficiency) or those who poorly tolerate increased dialysis duration or frequency. In such cases the treatment of choice may involve plasma dialysis procedures as suggested by us.