I am currently working on my Thesis about the maximization of the delivered hemodialysis Dose and stumbled about the BoD and PoD techniques mentioned in "Hemodiafiltration: Technical and Clinical Issues" by Claudio Ronco (DOI: 10.1159/000437403).
Those ideas seem very promising to me but i can hardly find anything about BoD or PoD, unfortunately there are also remarks in the Paper itself.
Do you guys know any paper, clinicaltrial or similar, testing or mentioning those techniques?
Thanks in Advance!
Thanks for this important question
In my practice as head of Alkafeel center of nephrology and kidney transplantation in Kerbala Holy Iraq i found that the high convective fluxes have been correlated with better clinical outcomes. Sometimes, however, there are technical barriers to the achievement of high blood flows adequate to perform effective therapies.Two solutions are used for the progressive increase TMP above 200, the hyperviscosity due to hemoconcentration and blood path resistance.This is achieved via specific software in the dialysis machine: predilution on demand and backflush on demand.
1.Predilution on demand or Pod consists in an automatic feedback of the machine, diverting part of the filtered dialysate into a predilution mode with an infusion of 200 ml in 30 s while the ultrafiltration pump stops. This results in a sudden hemodilution with a return of the parameters to acceptable values.
2.Backflush on demand BoD:
consists in an automatic positive pressure in the dialysate due to a stop of filtration and rapid back infusion of 100 ml or more of ultrapure dialysate into the hollow fiber. This results in a significant hemodilution,and backflushes of the membrane pores and improving membrane permeability.
Clin Nephrol. 2009 Dec;72(6):442-8.
Effective removal of leptin via hemodiafiltration with on-line endogenous reinfusion therapy
Hemodiafiltration: Technical and Clinical Issues
Ronco C.
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Keywords: Online hemodiafiltrationUltrafiltrationPredilutionBackfiltrationConvection
Blood Purif 2015;40(suppl 1):2-11
Thank you for your answer Riyadh Alsaegh !
But otherwise there are no studies or papers indicating a benefit of PoD or BoD, right?
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