{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T21:23:00Z","timestamp":1791235380569,"version":"4.1.0"},"reference-count":25,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2022,3,22]],"date-time":"2022-03-22T00:00:00Z","timestamp":1647907200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Seminars in Dialysis"],"published-print":{"date-parts":[[2022,9]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>High\u2010volume hemodiafiltration involves filtration of &gt;23\u2009L\/treatment and its replacement by sterile non\u2010pyrogenic substitution fluid, while maintaining the patient's fluid balance. That volume of substitution fluid precludes the use of prepackaged sterile fluid. Instead, substitution fluid must be prepared on\u2010line using machines that incorporate a series of bacteria\u2010 and endotoxin\u2010retentive filters. The sterilizing ultrafilters are validated to deliver sterile, non\u2010pyrogenic fluid to the patient when operated according to the machine manufacturer's instructions and in compliance with international standards and regulatory oversight. A successful hemodiafiltration program also places important responsibilities on the user. Specifically, the user is responsible for ensuring that the dialysis water or dialysis fluid delivered to the sterilizing filters of the hemodiafiltration machine meets the machine manufacturer's specifications and is consistent with the quality used in the sterilization validation process. The user is also responsible for ensuring that the treatment prescription allows a filtration volume &gt;23\u2009L\/treatment to be achieved by careful selection of a dialyzer, blood flow rate and treatment time. Questions related to assurance that the substitution fluid will routinely be sterile and non\u2010pyrogenic have limited the uptake of on\u2010line hemodiafiltration as a therapeutic option in some countries, such as the United States.<\/jats:p>","DOI":"10.1111\/sdi.13073","type":"journal-article","created":{"date-parts":[[2022,3,22]],"date-time":"2022-03-22T13:32:20Z","timestamp":1647955940000},"page":"385-389","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Basic prerequisites for on\u2010line, high\u2010volume hemodiafiltration"],"prefix":"10.1111","volume":"35","author":[{"given":"Richard A.","family":"Ward","sequence":"first","affiliation":[{"name":"Nelson New Zealand"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2022,3,22]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1093\/oxfordjournals.ndt.a027961"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen\u20102019\u2010033228"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1093\/ndt\/gfv349"},{"key":"e_1_2_8_5_1","unstructured":"Food and Drug Administration.Guidance for the Content of Premarket Notifications for Hemodialysis Delivery Systems. 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