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Nephrol Dial Transplant (2000) 15: 49-54
© 2000 European Renal Association-European Dialysis and Transplant Association

The impact of haemofiltration on the systemic cardiovascular response

Antonio Santoro, Elena Mancini and Pietro Zucchelli

Malpighi Division of Nephrology and Dialysis, Policlinico S. Orsola-Malpighi, Bologna, Italy

Convective transport across the dialysis membrane has long been known to be a good alternative to diffusion. Among the advantages of haemofiltration over conventional haemodialysis is a better cardiovascular stability. Haemofiltration has a more physiological response to fluid removal than haemodialysis: (i) blood volume may be better preserved, especially in patients with a compromised cardiac function; (ii) arterial peripheral resistances and venous tone increase; and (iii) myocardial contractility is neither depressed nor altered. We discuss the role of the different pathophysiological mechanisms in the disparity in cardiovascular reactivity between haemofiltration and haemodialysis.

Keywords: blood pressure; cardiovascular reactivity; haemodialysis; haemofiltration

Correspondence and offprint requests to: Dr Antonio Santoro, Malpighi Division of Nephrology and Dialysis, Policlinico S. Orsola-Malpighi, via P. Palagi 9, 40138 Bologna, Italy.


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