General Discussion

Abstract

The different novel approaches discussed in this symposium include dialysate regeneration, wearable artificial kidney, portable artificial kidney, hemofiltration, encapsulated charcoal hemcperfusion, oral adsorbents and combinations of these approaches. Each of these different approaches has certain advantages and disadvantages and a combined approach of the different principles appears most promising. Except for hemoperfusion, the general comparative perspectives of the different approaches have already been discussed in detail by Professor Kolff in the opening lecture and by Dr. Burton in the panel discussion. In the case of encapsulated charcoal hemoperfusion, extensive clinical trial for chronic renal failure has just been initiated as commercial systems become more widely available recently. Except for water, electrolytes and urea, encapsulated charcoal hemoperfusion removes the same uremic metabolites as dialysate regeneration except that hemoperfusion can do this much more efficiently. Adsorbent hemoperfusion in series with hemodialysis tested here has now been used successfully by a number of centers. This has resulted in a significant decrease in the time required for treatment.