Hemofiltration is to use a pump or the patient’s own pressure to make blood flow into a filter and excessive fluid and solutes will be filtered under filtration pressure. At the same time, substitute will be supplied to the blood so as to achieve the purpose of blood purification.
The filtered fluid and solutes are called ultrafiltrate and substitute is electrolyte solution which has the similar components with that of plasma. The filtration of ultrafiltrate functions as renal glomeruli and supply of substitute functions as renal tubules.
What are the advantages of hemofiltration?
Hemofiltration has higher clearance rate of medium-molecular substances than hemodialysis and it has better curative effects in the following cases.
1. Heart failure due to hypervolemia (high blood volume). Hemodialysis will worsen heart failure while hemofiltration can treat heart failure.
2. Refractory hypertension. The incidence of refractory hypertension is 50% among hemodialysis patients and it can be lowered to 1% in case of hemofiltration and sometimes antihypertensive medicines can be stopped.
3. Hypotension and severe retention of water and sodium. The incidence of hypotension in hemodialysis is 25% to 50% and that in hemofiltration it is 5%.
4. Acute renal failure. Continuous or intermittent hemofiltration is an effective treatment for acute failure of kidney functions. CAVH (continuous arteriovenous hemofiltration) has particular effects on elderly patients especially those that have unstable cardiovascular function or have multiple organ failures.
5. Hepatic coma. Many scholars think that hemofiltration has better curative effects on hepatic coma than hemodialysis but is not as good as that of plasma exchange and blood perfusion.
How to treat complications of hemofiltration?
While receiving hemofiltration, patients might have same complications as that in hemodialysis. Besides, there will also be the following complications.
1. Pyrogen reaction and sepsis. Substitute will be injected into the patients’ body and in case of substitute being polluted; patients may have pyrogen reaction and sepsis. Treatment mainly adopts antibiotics.
2. Loss of amino acid and proteins. Amino acids and proteins can be filtered out along with other metabolic wastes and excessive water and electrolytes. Treatment for this condition is increase protein intake through diets.
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