Technical advances in hemodialysis therapy.
Other than pharmaceutical advancements, the improvements in hemodialysis have largely been due to technical changes. This article summarizes the various technical areas that are noteworthy: hemodialysis membranes; dialysate buffer, electrolyte concentration, and temperature; prescription monitoring; reprocessing; volume-ultrafiltration control; information system interface; arteriovenous access monitoring; water treatment; and continuous and nocturnal dialysis. Within each category, subjective and objective conclusions are drawn as to whether the technical advancements have translated to improved clinical outcomes. In addition, an hypothesis is proposed that due to a confluence of ownership of research and development, manufacturing of equipment, and dialysis facilities conflicts may arise which could slow future technical developments.
Parker
T F
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Dallas Nephrology Associates and the Department of Medicine, University of Texas Southwestern Medical School, USA. tfparker3@cs.com
D001166:Arteriovenous Shunt, Surgical; D017743:Equipment Reuse; D015312:Hemodialysis Solutions; D006801:Humans; D008567:Membranes, Artificial; D006435:Renal Dialysis / Q000295:instrumentation / Q000379:methods / Q000639:trends
D015312:Hemodialysis Solutions; D008567:Membranes, Artificial