On-line hemodiafiltration in critical care.

On-line products of substitution fluid permits virtually unlimited fluid volume exchange during continuous hemodiafiltration (CHDF) to critical care. In on-line hemodiafiltration (HDF), endotoxin free dialysate obtained using pyrogen cut filters is infused into the blood circuit, and HDF is automatically performed using the closed-loop balancing system of the dialysis machine. On-line CHDF is the application of this on-line HDF to continuous renal replacement therapy in the critical care field. We performed on-line CHDF on 376 acute renal failure patients during a 5 year period, and the mean survival rate was 62.5%. We concluded that the on-line CHDF system is safe and effective at maintaining acute renal failure patients.