title: [Hemodialysis in patients with chronic renal insufficiency].
abstract: Hemodialysis is the most advanced form of artificial renal support. It ensures the survival of almost 2 million patients wordwide. Considerable progress has been made in recent years thanks to a better understanding of uremia, optimization of treatment modalities and more personalized treatment schedules. Increase of uremic toxins removal, improvement of hemodynamic tolerance of the sessions, reduction of proinflammatory reactions due to the bioincompatibility system are major advances that may explain the reduction of morbidity and mortality in dialysis patients. New technologies (nanotechnology, biotechnology, microelectronics) are now expected to introduce further progresses by miniaturizing devices and providing them with an "artificial intelligence" capable of interacting with the patient. The main obstacle remains ageing of uremic patients, increasing prevalence of comorbidities and shortage of social resources that are not conducive to innovation. By promoting a more physiological, longer and more effective hemodialysis performed at home with help of teledialysis monitoring that would probably be an interesting option to evaluate on a medico-economical point of view.
authors.affiliation: Service de néphrologie, dialyse et soins intensifs, hôpital Lapeyronie, CHRU de Montpellier, 34925 Montpellier Cedex 5. b-canaud@chu-montpellier.fr
authors.forename: Bernard
authors.initials: B
authors.lastname: Canaud
authors.forename: Hélène
authors.initials: H
authors.lastname: Leray-Moragués
authors.forename: Leila
authors.initials: L
authors.lastname: Chenine-Koualef
authors.forename: Laure
authors.initials: L
authors.lastname: Patrier
mesh_terms: D005602:France / Q000453:epidemiology; D006437:Hemodialysis, Home / Q000639:trends; D006801:Humans; D007676:Kidney Failure, Chronic / Q000628:therapy; D016030:Kidney Transplantation / Q000639:trends*; D008991:Monitoring, Physiologic; D006435:Renal Dialysis / Q000639:trends*; D051436:Renal Insufficiency, Chronic / Q000401:mortality / Q000601:surgery / Q000628:therapy*; D012307:Risk Factors; D015996:Survival Rate; D013997:Time Factors; D016896:Treatment Outcome; D014850:Waiting Lists