Hemofiltration / Hemodiafiltration (2)

What it is and how it works

These sterile electrolyte solutions, usually buffered with bicarbonate (or lactate), are infused into the extracorporeal circuit as replacement fluid in haemofiltration or used as dialysate and replacement fluid in haemodiafiltration. They replace the large volume of plasma water removed by convection and diffusion, restoring electrolyte and acid–base balance while uraemic solutes are cleared.

Indications

Continuous or intermittent renal replacement therapy (haemofiltration, haemodiafiltration, haemodialysis) in acute kidney injury and chronic renal failure, and in fluid overload, electrolyte and acid–base disturbances or certain intoxications.

Dosage and administration (summary)

Dosing is individualised by the nephrology or intensive care specialist according to the prescribed therapy dose (effluent rate), the patient’s fluid balance, electrolytes and acid–base status.

Contraindications

Contraindications relate to the specific electrolyte composition (e.g. potassium-containing solutions in hyperkalaemia, bicarbonate solutions in metabolic alkalosis); there are no others for the solution itself when renal replacement therapy is indicated.

Warnings and precautions

Plasma electrolytes (including potassium, sodium, calcium, magnesium and phosphate), glucose and acid–base status must be monitored closely and supplemented as necessary. Two-compartment bags must be mixed immediately before use, the solution must be clear and the bag intact, and the solution should be warmed to near body temperature; inaccurate fluid balance can cause hypovolaemia or overload.

Storage and supply

Store at room temperature; do not freeze.

Source: reference summary prepared from the EU SmPC/EPAR, BNF and WHO Model Formulary. The approved product information in Iran governs.