Hemofiltration pp 309-315 | Cite as

The Future of Hemofiltration

  • L. W. Henderson


Predilution hemofiltration (HF) was initiated as a test strategy to evaluate the pathophysiologic significance of “middle molecules” for the uremic patient [1, 2]. As such, the system was devised for use in the patient with stable end stage renal failure (ESRF). As originally applied, it was recognized to be at a disadvantage in the removal of low molecular weight solutes (<350 daltons) when compared with hemodialysis (HD). Since then many changes have occurred in how convective mass transport is applied. Postdilution vs predilution [3] as a means of economizing on diluting fluid, hemodiafiltration (HDF)[4,5,6] which combines the best of both diffusion and convection, and continuous low efficiency HF for the treatment of acute renal failure (ARF)[7] are some of the creative applications to which this ultrafiltration methodology has been put. In placing this spectrum of techniques into the special perspective of “the future of hemofiltration” I wish to take a brief backward look in order to have you join me in extrapolating this line of development into the future.


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. 1.
    Henderson LW (1977) Development of a convective blood cleansing technique. Proceedings of the 10th Annual Contractors Conference, Bethesda, Maryland, p 130Google Scholar
  2. 2.
    Henderson LW (1981) The beginning of hemofiltration. In: Beryne GM, Giovannetti S, Thomas S (eds) Contributions to nephrology series, vol 32. Shaefer K, Koch KM, Quellhorst E, von Herrath D (eds) Symposium on hemofiltration volume. Karger, Basel, p 1Google Scholar
  3. 3.
    Henderson LW (1979) Pre- vs. postdilution hemofiltration. Clin Nephrol 11: 120PubMedGoogle Scholar
  4. 4.
    Leber HW, Wizemann V, Goubeaud G, Rawer P, Schutterle G (1978) Simultaneous hemofiltration/hemodialysis: an effective alternative to hemofiltration and conventional hemodialysis in the treatment of uremic patients. Clin Nephrol 9: 115PubMedGoogle Scholar
  5. 5.
    Cheung AK, KatoY, Leypoldt JK, Henderson LW (1982) Hemodiaflltration using a hybrid membrane system for self-generation of diluting fluid. Trans Am Soc Artif Intern Organs 28: 61PubMedGoogle Scholar
  6. 6.
    von Albertini B, Miller JH, Gardner PW, Norris KC, Roberts CE, Shinaberger JH (1984) High flux hemodiaflltration. Abstract, American Society for Nephrology, 17th annual meeting, p 76Google Scholar
  7. 7.
    Kramer P (ed) (1982) Arterio-venous hemofiltration, Vandenhoeck and Ruprecht, GottingenGoogle Scholar
  8. 8.
    Kolff WJ (1965) First clinical experience with the artificial kidney. Ann Intern Med 62: 608PubMedCrossRefGoogle Scholar
  9. 9.
    McBride PT (1979) Genesis of the artificial kidney, chap 3. Travenol Labs, Deerfield, Illinois, USA, p9Google Scholar
  10. 10.
    Quinton WE, Dillard DH, Cole JJ, Scribner BH (1962) Eight months experience with silasticteflon bypass cannulas. Trans Am Soc Artif Intern Organs 8: 236PubMedCrossRefGoogle Scholar
  11. 11.
    Henderson LW, Besarab A, Michaels A, Bluemle LW Jr (1967) Blood purification by ultrafiltration and fluid replacement (diafiltration). Trans Am Soc Artif Intern Organs 12: 216Google Scholar
  12. 12.
    Silverstein ME, Ford CA, Lysaght MJ, Henderson LW (1974) Treatment of severe fluid overload by ultrafiltration. N Engl J Med 291: 747PubMedCrossRefGoogle Scholar
  13. 13.
    Paganini EP, Nakamoto S (1980) Continuous slow flow ultrafiltration in oliguric acute renal failure. Trans Am Soc Artif Intern Organs 26: 203Google Scholar
  14. 14.
    Leypoldt JK, Frigon RP, Henderson LW (1985) Characterization of solutes transport in membrane ultrafiltration. J Membrane Sci (in review)Google Scholar
  15. 15.
    Maeda K, Shinzato T, Sezaki R, Yamada K, Saito A, Ohta K (1984) Decrease sieving coefficient for middle molecule during hemofiltration and infusion free hemodiaflltration. Blood Purif 2: 54 (Abstract)Google Scholar
  16. 16.
    Icardi A, Lamperi B, Cappelli G, Lamperi S (1984) Hemofiltration and biofiltration: a comparative study on the short term effects. Blood Purif 2: 52 (Abstract)Google Scholar
  17. 17.
    Henderson LW, Beans E (1978) Successful production of sterile pyrogen free electrolyte solution by ultrafiltration. Kidney Int 14: 522PubMedCrossRefGoogle Scholar
  18. 18.
    Henderson LW, Sanfelippo ML, Beans E (1978) “On line” preparation of sterile pyrogen free electrolyte solution. Trans Am Soc Artif Intern Organs 24: 465PubMedGoogle Scholar
  19. 19.
    Baldamus CA (1983) Clinical value and technical feasibility of long term hemofiltration. Assaio J 6: 192Google Scholar
  20. 20.
    Bosch JP, von Albertini B, Geronemus R, Glabman S, Goldstein MH, Kahn T, Kupfer S (1979) Comparison of hemofiltration and ultrafiltration plus hemodialysis to conventional hemodialysis. Annual Progress report to the Artificial Kidney Chronic Uremia Program, National Institute of Arthritis, Metabolic and Digestive Diseases, 15 March 1979Google Scholar
  21. 21.
    Henderson LW (1980) Symptomatic hypotension during hemodialysis. Kidney Int 17: 571PubMedCrossRefGoogle Scholar
  22. 22.
    Quellhorst EA, Schuenemann B, Hildebrand U (1983) Morbidity and mortality in long term hemofiltration. Asaio J 6: 185Google Scholar
  23. 23.
    Baldamus CA, Ernst W, Fassbinder W, Koch KM (1980) Differing haemodynamics stability due to differing sympathetic response: comparison of ultrafiltration, haemodialysis and haemofiltration. Proc Eur Dial Transplant Assoc 17: 205PubMedGoogle Scholar
  24. 24.
    Quellhorst E, Schuenemann B, Hildebrand U, Falda Z (1980) Response of the vascular system to different modifications of haemofiltration and haemodialysis. Proc Eur Dial Transplant Assoc 17: 197PubMedGoogle Scholar
  25. 25.
    Graefe U, Milutinovich J, Follette WC, Vizzo JE, Babb AL, Scribner BH (1978) Less dialysis induced morbidity and vascular instability with bicarbonate and dialysate. Ann Intern Med 88: 332PubMedCrossRefGoogle Scholar
  26. 26.
    Schuenemann B, Quellhorst E, Kaiser H, Richter G, Mündt K, Weidlich E, Loeffler G, Zachariae M and Schunk O (1982) Regeneration of filtrate and dialysis fluid by electro-oxidation and absorption. Trans Am Soc Artif Intern Organs 28: 49PubMedGoogle Scholar
  27. 27.
    Wright JC (1982) Electrochemical dialysate regeneration: the electrooxidation of urea at the ruthenium titanium oxide electrode. Ph D Dissertation, Stanford UniversityGoogle Scholar
  28. 28.
    Shaldon S, Beau MC, Deschodt G, Lysaght MJ, Ramperez P, Mion C (1980) Continuous ambulatory hemofiltration. Trans Am Soc Artif Intern Organs 26: 210PubMedGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 1986

Authors and Affiliations

  • L. W. Henderson

There are no affiliations available

Personalised recommendations