Dialysis

Online Haemodiafiltration - Because we want our patients to live longer and better.

about Online Haemodiafiltration

OL-HDF (Online hemodiafiltration) is widely recognised as a safer, more comfortable and more efficient alternative to conventional hemodialysis.

Online Haemodiafiltration:

About haemodiafiltration

HDF is a renal replacement technique combining two principles – diffusion and convection. The convective process is based on the ultrafiltration of large amounts of plasma water across the membrane. This allows for the effective removal of larger solutes due to convection in addition to the diffusive transport of small molecules.

To maintain the fluid balance necessary to replace the additional ultrafiltration volume, ideally after the dialyser, the so-called post-dilution HDF.

Volume matters

Recent publications have demonstrated that a large convective volume in post-dilution mode is required in order to maximise the benefits of HDF therapy. The production of large amounts of substitution volume is no longer a challenge. Today maximising substitution volume for each patient requires a new therapeutic approach – Online Haemodiafiltration.

Online Haemodiafiltration with its numerous positive effects on dialysis-related cardiovascular risk factors is acknowledged as the most effective dialysis treatment modality, coming closer to the elimination profile of the natural kidney.

By achieving high substitution volumes, Online Haemodiafiltration therapy is credited with more effective elimination of middle molecules. It improves patient outcomes and exerts beneficial effects on the main cardiovascular risk factors:

  • Serum ß2-m and phosphate level
  • Inflammatory response
  • Intradialytic haemodynamic stability
  • Anaemia control

These factors contribute to better quality of life and improved patient survival.

Reduced mortality risk

The Catalonian high-volume HDF study shows a significant 30% reduction in all-cause mortality for patients with Online Haemodiafiltration. The estimated number needed to treat showed that to prevent one death per year eight patients would need to be switched from HighFlux HD to Online Haemodiafiltration.

30% Lower risk of all-cause mortality
33% Lower risk of cardiovascular mortality
55% Lower risk of
infection-related mortality
28% Lower risk of cardiovascular mortality
22% Lower risk of infection-related mortality

Enjoy advanced HDF treatment and its beneficial effects in an unforgettable Mediterranean setting.

Don’t miss out on this amazing, therapeutical experience!

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Stage 1 CKD is diagnosed when a person has kidney damage and CKD risk factors with normal or high GFR. In Stage 1, there are often few to no symptoms. Management includes a healthy diet, blood pressure regulation and good glucose control in people with diabetes.

In Stage 2 CKD, the GFR is mildly decreased between 60-89, indicating the person has kidney damage and mild loss of kidney function. Similar to Stage 1 CKD, following a healthy diet, controlling blood pressure and managing diabetes are key ways to slow the progression of CKD.

Signs of stage 2 kidney disease include:

Higher than normal levels of creatinine or urea in the blood, blood or protein in the urine, evidence of kidney damage in an MRI, CT scan, ultrasound or contrast X-ray οr family history of polycystic kidney disease (PKD).

Regular testing for protein in the urine and serum creatinine can show whether the kidney damage is progressing. Living a healthy lifestyle can help slow progression of kidney disease. Limit intake of refined and processed foods high in sugar and sodium, choose and prepare foods with less salt or high-sodium ingredients, aim for a healthy weight. Have regular checkups with their doctor and include a serum creatinine test to measure GFR, keep your blood pressure at a healthy level (125/75 for those with diabetes, 130/85 for non-diabetes and non-proteinuria), Keep your blood sugar or diabetes under control.

Diagnosis

A person with stage 3 chronic kidney disease (CKD) has moderate kidney damage. This stage is divided into two subclasses: a decrease in glomerular filtration rate (GFR) for Stage 3A is 45-59 mL/min and a decrease in GFR for Stage 3B is 30-44 mL/min.

Symptoms

Symptoms may start to become present in stage 3: Fatigue, fluid retention, swelling (edema) of extremities, urination changes (foamy urine; dark orange, brown, tea-colored or red if it contains blood; and urinating more or less than normal).

Treatment

At stage 3 progresses a patient should see a nephrologist (a doctor who specializes in treating kidney disease).

Someone in stage 3 may also be referred to a dietitian. For stage 3 CKD, a healthy diet is likely to consist of: Eating high-quality protein and potassium (if blood levels are above normal), consuming a some grains, fruits and vegetables (potassium and phosphorus are at normal levels), limiting phosphorus to help PTH levels remain normal, prevent bone disease and even preserve existing kidney function, lowering sodium for people with high blood pressure or fluid retention by cutting out processed and pre-packaged foods, limiting calcium if blood levels are too high.

Many people who develop CKD have diabetes or high blood pressure. By keeping their glucose level under control and maintaining a healthy blood pressure, this can help them preserve their kidney function.

There is no cure for kidney disease, but it may be possible to stop its progress or at least slow down the damage. In many cases, the correct treatment and lifestyle changes can help keep a person and their kidneys healthier longer.

Diagnosis

When CKD has progressed to Stage 4, it's time to begin preparing for dialysis. If GFR falls below 30, people should visit a kidney doctor (called a nephrologist) and talk about treatment options. People may develop complications, such as high blood pressure, anemia, bone disease and cardiovascular diseases.

Symptoms

Symptoms include fatigue, fluid retention, swelling (edema) of extremities and shortness of breath, urination changes (foamy; dark orange, brown, tea-colored or red if it contains blood; Sleep problems due to muscle cramps or restless legs.

Nausea and/or vomiting, taste changes, metallic taste in the mouth, bad breath due to urea buildup in the blood, loss of appetite: difficulty in concentrating (having trouble doing everyday things such as balancing a checkbook or focusing on reading the newspaper can occur), nerve problems: numbness or tingling in the toes or fingers is a symptom of CKD.

Treatment

At stage 4, it’s necessary to see a nephrologist (a doctor who specializes in treating kidney disease). Those with stage 4 CKD who will need treatment are told about their choices, including:

  • 1) Hemodialysis
  • 2) Peritoneal dialysis (PD)
  • 3) Kidney transplantation

For stage 4 CKD, a healthy diet is likely to consist of: Reducing protein consumption to help decrease the buildup of protein waste, consuming a some grains, fruits and vegetables (potassium and phosphorus are at normal levels), limiting phosphorus to help PTH levels remain normal, prevent bone disease and even preserve existing kidney function, restricting potassium if blood levels are above normal, lowering calcium consumption, cutting back carbohydrates for those with diabetes.

It’s recommended that people in stage 4 keep their blood pressure at a healthy level and those with diabetes keep their glucose level under control. Taking all the medicines as prescribed by the doctor may help prolong kidney function.

Diagnosis

A person with Stage 5 CKD has end stage renal disease (ESRD) with a GFR less than 15 ml/min. People with Stage 5 CKD will need to consider a couple of different treatment options, such as dialysis (a treatment that removes wastes and excess fluid from your body) or a kidney transplant.

Symptoms

Symptoms that can occur in stage 5 CKD include: Loss of appetite, nausea or vomiting, headaches, being tired, being unable to concentrate, itching, decreased urine output, swelling, especially around the eyes and ankles, muscle cramps, tingling in hands or feet, changes in skin color, increased skin pigmentation. Because the kidneys are no longer able to remove waste and fluids from the body, toxins build up in the blood, causing an overall ill feeling. Kidneys are no longer able to regulate blood pressure and produce hormones such as erythropoietin and vitamin D.

Treatment

If you are diagnosed with stage 5 CKD, you will need to see a nephrologist immediately. This is a doctor who is trained in kidney disease, kidney dialysis and transplantation. The doctor will help you decide which treatment is best for you—hemodialysis, peritoneal dialysis (PD) or kidney transplantation—and will recommend an access for dialysis.

Τhere are two types of dialysis modalities for people with stage 5 kidney disease.

  • 1) Hemodialysis: A dialysis machine removes a small amount of a patient’s blood through a man-made membrane called a dialyzer, or artificial kidney, to clean out toxins that the kidneys can no longer remove. The filtered blood is then returned to the body.
  • 2) Peritoneal dialysis (PD): Unlike hemodialysis, PD is a needle-free treatment and a care partner is not required to assist during treatment. PD can be performed at home or at work.
  • 3) Kidney transplantation is the only treatment of end stage renal disease.

Once you begin dialysis, you will need to make changes in what you eat and drink. Your diet is a big part of your treatment, so you will be working with a dietitian who will coach you on how you should eat.

What Stage Am I In?

There are five stages of kidney disease. Your glomerular filtration rate (GFR) lets nephrologists figure out your stage of kidney disease. Determining your GFR levels requires a simple blood test.

What Your GFR Result Means

Completely healthy kidney function is measured at a GFR of around 100, which means that the kidneys are working at 100 percent. The kidney function is still considered normal if the GFR number is 90 or greater.

Stage 1 CKD is diagnosed when a person has kidney damage and CKD risk factors with normal or high GFR. In Stage 1, there are often few to no symptoms. Management includes a healthy diet, blood pressure regulation and good glucose control in people with diabetes.

In Stage 2 CKD, the GFR is mildly decreased between 60-89, indicating the person has kidney damage and mild loss of kidney function. Similar to Stage 1 CKD, following a healthy diet, controlling blood pressure and managing diabetes are key ways to slow the progression of CKD.

Signs of stage 2 kidney disease include:

Higher than normal levels of creatinine or urea in the blood, blood or protein in the urine, evidence of kidney damage in an MRI, CT scan, ultrasound or contrast X-ray οr family history of polycystic kidney disease (PKD).

Regular testing for protein in the urine and serum creatinine can show whether the kidney damage is progressing. Living a healthy lifestyle can help slow progression of kidney disease. Limit intake of refined and processed foods high in sugar and sodium, choose and prepare foods with less salt or high-sodium ingredients, aim for a healthy weight. Have regular checkups with their doctor and include a serum creatinine test to measure GFR, keep your blood pressure at a healthy level (125/75 for those with diabetes, 130/85 for non-diabetes and non-proteinuria), Keep your blood sugar or diabetes under control.

Diagnosis

A person with stage 3 chronic kidney disease (CKD) has moderate kidney damage. This stage is divided into two subclasses: a decrease in glomerular filtration rate (GFR) for Stage 3A is 45-59 mL/min and a decrease in GFR for Stage 3B is 30-44 mL/min.

Symptoms

Symptoms may start to become present in stage 3: Fatigue, fluid retention, swelling (edema) of extremities, urination changes (foamy urine; dark orange, brown, tea-colored or red if it contains blood; and urinating more or less than normal).

Treatment

At stage 3 progresses a patient should see a nephrologist (a doctor who specializes in treating kidney disease).

Someone in stage 3 may also be referred to a dietitian. For stage 3 CKD, a healthy diet is likely to consist of: Eating high-quality protein and potassium (if blood levels are above normal), consuming a some grains, fruits and vegetables (potassium and phosphorus are at normal levels), limiting phosphorus to help PTH levels remain normal, prevent bone disease and even preserve existing kidney function, lowering sodium for people with high blood pressure or fluid retention by cutting out processed and pre-packaged foods, limiting calcium if blood levels are too high.

Many people who develop CKD have diabetes or high blood pressure. By keeping their glucose level under control and maintaining a healthy blood pressure, this can help them preserve their kidney function.

There is no cure for kidney disease, but it may be possible to stop its progress or at least slow down the damage. In many cases, the correct treatment and lifestyle changes can help keep a person and their kidneys healthier longer.

Diagnosis

When CKD has progressed to Stage 4, it's time to begin preparing for dialysis. If GFR falls below 30, people should visit a kidney doctor (called a nephrologist) and talk about treatment options. People may develop complications, such as high blood pressure, anemia, bone disease and cardiovascular diseases.

Symptoms

Symptoms include fatigue, fluid retention, swelling (edema) of extremities and shortness of breath, urination changes (foamy; dark orange, brown, tea-colored or red if it contains blood; Sleep problems due to muscle cramps or restless legs.

Nausea and/or vomiting, taste changes, metallic taste in the mouth, bad breath due to urea buildup in the blood, loss of appetite: difficulty in concentrating (having trouble doing everyday things such as balancing a checkbook or focusing on reading the newspaper can occur), nerve problems: numbness or tingling in the toes or fingers is a symptom of CKD.

Treatment

At stage 4, it’s necessary to see a nephrologist (a doctor who specializes in treating kidney disease). Those with stage 4 CKD who will need treatment are told about their choices, including:

  • 1) Hemodialysis
  • 2) Peritoneal dialysis (PD)
  • 3) Kidney transplantation

For stage 4 CKD, a healthy diet is likely to consist of: Reducing protein consumption to help decrease the buildup of protein waste, consuming a some grains, fruits and vegetables (potassium and phosphorus are at normal levels), limiting phosphorus to help PTH levels remain normal, prevent bone disease and even preserve existing kidney function, restricting potassium if blood levels are above normal, lowering calcium consumption, cutting back carbohydrates for those with diabetes.

It’s recommended that people in stage 4 keep their blood pressure at a healthy level and those with diabetes keep their glucose level under control. Taking all the medicines as prescribed by the doctor may help prolong kidney function.

Diagnosis

A person with Stage 5 CKD has end stage renal disease (ESRD) with a GFR less than 15 ml/min. People with Stage 5 CKD will need to consider a couple of different treatment options, such as dialysis (a treatment that removes wastes and excess fluid from your body) or a kidney transplant.

Symptoms

Symptoms that can occur in stage 5 CKD include: Loss of appetite, nausea or vomiting, headaches, being tired, being unable to concentrate, itching, decreased urine output, swelling, especially around the eyes and ankles, muscle cramps, tingling in hands or feet, changes in skin color, increased skin pigmentation. Because the kidneys are no longer able to remove waste and fluids from the body, toxins build up in the blood, causing an overall ill feeling. Kidneys are no longer able to regulate blood pressure and produce hormones such as erythropoietin and vitamin D.

Treatment

If you are diagnosed with stage 5 CKD, you will need to see a nephrologist immediately. This is a doctor who is trained in kidney disease, kidney dialysis and transplantation. The doctor will help you decide which treatment is best for you—hemodialysis, peritoneal dialysis (PD) or kidney transplantation—and will recommend an access for dialysis.

Τhere are two types of dialysis modalities for people with stage 5 kidney disease.

  • 1) Hemodialysis: A dialysis machine removes a small amount of a patient’s blood through a man-made membrane called a dialyzer, or artificial kidney, to clean out toxins that the kidneys can no longer remove. The filtered blood is then returned to the body.
  • 2) Peritoneal dialysis (PD): Unlike hemodialysis, PD is a needle-free treatment and a care partner is not required to assist during treatment. PD can be performed at home or at work.
  • 3) Kidney transplantation is the only treatment of end stage renal disease.

Once you begin dialysis, you will need to make changes in what you eat and drink. Your diet is a big part of your treatment, so you will be working with a dietitian who will coach you on how you should eat.

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