{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,5]],"date-time":"2026-05-05T02:22:28Z","timestamp":1777947748751,"version":"3.51.4"},"reference-count":97,"publisher":"Wiley","issue":"1-2","license":[{"start":{"date-parts":[[2026,2,22]],"date-time":"2026-02-22T00:00:00Z","timestamp":1771718400000},"content-version":"vor","delay-in-days":52,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Seminars in Dialysis"],"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Japan leads globally in HDF adoption, with online predilution HDF used in the majority of HDF treatments. Although associated with excellent outcomes, predilution HDF requires large substitution volumes and high dialysate production, raising sustainability concerns.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This study employed a narrative review integrating expert consensus, Japanese registry data (JSDT), dialysis system specifications, and comparative clinical and kinetic literature to contrast predilution and postdilution strategies and derive an implementation pathway.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Postdilution HDF provides higher convective efficiency and solute removal per liter of fluid than predilution HDF, enabling comparable performance with lower total fluid requirements when prescriptions are optimized. A stepwise transition strategy is proposed: (1) progressive blood flow optimization; (2) selection of HDF\u2010appropriate dialyzers with strict albumin permeability control; (3) anticoagulation optimization for higher filtration fractions; (4) gradual introduction and escalation of postdilution convection with automated fluid control; (5) dialysate\u2010to\u2010blood flow alignment allowing reduction of total dialysate flow while preserving clearance; and (6) iterative monitoring of efficacy and tolerance using clinical targets and biomarker response.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>A pragmatic transition toward optimized postdilution HDF can preserve Japan's high\u2010quality dialysis care while improving resource efficiency. Registry\u2010based evaluations and targeted randomized studies are needed to confirm clinical outcomes and quantify economic and environmental benefits.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/sdi.70018","type":"journal-article","created":{"date-parts":[[2026,2,23]],"date-time":"2026-02-23T00:00:38Z","timestamp":1771804838000},"page":"33-43","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Advancing Postdilution Hemodiafiltration for Global Sustainability: A Japanese Blueprint"],"prefix":"10.1111","volume":"39","author":[{"given":"Kenji","family":"Sakurai","sequence":"first","affiliation":[{"name":"Hashimoto Clinic  Kanagawa Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ikuto","family":"Masakane","sequence":"additional","affiliation":[{"name":"Yabuki Hospital  Yamagata Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Akihiro\u00a0C.","family":"Yamashita","sequence":"additional","affiliation":[{"name":"Department of Chemical Science and Technology, Faculty of Bioscience and Applied Chemistry Hosei University  Tokyo Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hideki","family":"Kawanishi","sequence":"additional","affiliation":[{"name":"Tsuchiya General Hospital  Hiroshima Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6854-2816","authenticated-orcid":false,"given":"Bernard","family":"Canaud","sequence":"additional","affiliation":[{"name":"Montpellier University  Montpellier France"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2026,2,22]]},"reference":[{"key":"e_1_2_9_2_1","unstructured":"United States Renal Data System \u201c2022 USRDS Annual Data Report: Epidemiology of Kidney Disease in the United States \u201d National Institutes of Health National Institute of Diabetes and Digestive and Kidney Diseases Bethesda MD; (2022):2022."},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(20)30045-3"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(14)61601-9"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1186\/s41100-021-00370-8"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1093\/ndt\/gfz005"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.ASN.0000100127.54107.57"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.2215\/CJN.02660221"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1093\/ndt\/gfy224"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.3390\/jcm13030647"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1053\/ajkd.2001.27450"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.34067\/KID.0000162020"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.4009\/jsdt.56.473"},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.1186\/s41100-023-00478-z"},{"key":"e_1_2_9_15_1","doi-asserted-by":"publisher","DOI":"10.1186\/s41100-019-0199-6"},{"key":"e_1_2_9_16_1","doi-asserted-by":"publisher","DOI":"10.4009\/jsdt.56.473"},{"key":"e_1_2_9_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.kint.2018.10.036"},{"key":"e_1_2_9_18_1","doi-asserted-by":"publisher","DOI":"10.1159\/000450810"},{"key":"e_1_2_9_19_1","doi-asserted-by":"publisher","DOI":"10.1093\/ckj\/sfae147"},{"key":"e_1_2_9_20_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1523-1755.2000.07411.x"},{"key":"e_1_2_9_21_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10157-021-02163-z"},{"key":"e_1_2_9_22_1","doi-asserted-by":"publisher","DOI":"10.1093\/ndt\/gfw249"},{"key":"e_1_2_9_23_1","doi-asserted-by":"publisher","DOI":"10.1111\/1744-9987.12294"},{"key":"e_1_2_9_24_1","doi-asserted-by":"publisher","DOI":"10.1111\/1744-9987.12293"},{"key":"e_1_2_9_25_1","doi-asserted-by":"publisher","DOI":"10.1159\/000320116"},{"key":"e_1_2_9_26_1","unstructured":"T.Akiba\u201cResults of the International DOPPS Hemodialysis Study in Japan \u201d JSDT."},{"key":"e_1_2_9_27_1","doi-asserted-by":"publisher","DOI":"10.1093\/ndt\/gft062"},{"key":"e_1_2_9_28_1","doi-asserted-by":"publisher","DOI":"10.1093\/ckj\/sfae153"},{"key":"e_1_2_9_29_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2019-031476"},{"key":"e_1_2_9_30_1","doi-asserted-by":"publisher","DOI":"10.1159\/000441573"},{"key":"e_1_2_9_31_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.ajkd.2017.09.012"},{"key":"e_1_2_9_32_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1523-1755.2003.00315.x"},{"key":"e_1_2_9_33_1","doi-asserted-by":"publisher","DOI":"10.1159\/000536537"},{"key":"e_1_2_9_34_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1744-9987.2010.00893.x"},{"key":"e_1_2_9_35_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0269849"},{"key":"e_1_2_9_36_1","doi-asserted-by":"publisher","DOI":"10.1111\/1744-9987.12378"},{"key":"e_1_2_9_37_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.jrn.2019.09.007"},{"key":"e_1_2_9_38_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.xkme.2020.01.007"},{"key":"e_1_2_9_39_1","doi-asserted-by":"publisher","DOI":"10.1093\/ndt\/gfn346"},{"key":"e_1_2_9_40_1","doi-asserted-by":"publisher","DOI":"10.1186\/s41100-017-0114-y"},{"key":"e_1_2_9_41_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1744-9987.2009.00674.x"},{"key":"e_1_2_9_42_1","doi-asserted-by":"publisher","DOI":"10.1111\/1744-9987.12031"},{"issue":"7","key":"e_1_2_9_43_1","first-page":"45","article-title":"Section IV. Dialysis Fluid Purity","volume":"17","author":"EBPG Expert Group on Haemodialysis ERA","year":"2002","journal-title":"Nephrology, Dialysis, Transplantation"},{"key":"e_1_2_9_44_1","doi-asserted-by":"publisher","DOI":"10.1007\/978-3-319-23332-1"},{"key":"e_1_2_9_45_1","doi-asserted-by":"publisher","DOI":"10.1007\/978-3-319-23332-1_8"},{"key":"e_1_2_9_46_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12882-021-02543-3"},{"key":"e_1_2_9_47_1","doi-asserted-by":"publisher","DOI":"10.1159\/000529991"},{"key":"e_1_2_9_48_1","doi-asserted-by":"publisher","DOI":"10.1111\/sdi.12567"},{"key":"e_1_2_9_49_1","doi-asserted-by":"publisher","DOI":"10.1093\/ndt\/gfu253"},{"key":"e_1_2_9_50_1","doi-asserted-by":"publisher","DOI":"10.1111\/1744-9987.12294"},{"key":"e_1_2_9_51_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.kint.2020.12.010"},{"key":"e_1_2_9_52_1","doi-asserted-by":"publisher","DOI":"10.34067\/KID.0003722021"},{"key":"e_1_2_9_53_1","doi-asserted-by":"publisher","DOI":"10.1093\/ckj\/sfab198"},{"key":"e_1_2_9_54_1","doi-asserted-by":"publisher","DOI":"10.1111\/hdi.12142"},{"key":"e_1_2_9_55_1","doi-asserted-by":"publisher","DOI":"10.1186\/s41100-020-00286-9"},{"key":"e_1_2_9_56_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa2304820"},{"key":"e_1_2_9_57_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10047-020-01167-y"},{"key":"e_1_2_9_58_1","doi-asserted-by":"publisher","DOI":"10.1681\/ASN.2024a6qb03an"},{"key":"e_1_2_9_59_1","doi-asserted-by":"publisher","DOI":"10.1186\/s41100-025-00678-9"},{"key":"e_1_2_9_60_1","doi-asserted-by":"publisher","DOI":"10.1093\/ndt\/gfad136"},{"key":"e_1_2_9_61_1","doi-asserted-by":"publisher","DOI":"10.1186\/s41100-019-0248-1"},{"key":"e_1_2_9_62_1","doi-asserted-by":"publisher","DOI":"10.1186\/s41100-021-00326-y"},{"key":"e_1_2_9_63_1","doi-asserted-by":"publisher","DOI":"10.1186\/s41100-021-00385-1"},{"key":"e_1_2_9_64_1","doi-asserted-by":"publisher","DOI":"10.1159\/000534459"},{"key":"e_1_2_9_65_1","doi-asserted-by":"publisher","DOI":"10.1111\/nep.14038"},{"key":"e_1_2_9_66_1","doi-asserted-by":"publisher","DOI":"10.1093\/ndt\/gfs530"},{"key":"e_1_2_9_67_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41598-024-60831-y"},{"key":"e_1_2_9_68_1","doi-asserted-by":"publisher","DOI":"10.1159\/000478032"},{"key":"e_1_2_9_69_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41598-021-91751-w"},{"key":"e_1_2_9_70_1","doi-asserted-by":"publisher","DOI":"10.3389\/fmed.2021.740461"},{"key":"e_1_2_9_71_1","doi-asserted-by":"publisher","DOI":"10.1093\/ckj\/sfab177"},{"key":"e_1_2_9_72_1","doi-asserted-by":"publisher","DOI":"10.1111\/1744-9987.13919"},{"key":"e_1_2_9_73_1","doi-asserted-by":"publisher","DOI":"10.1093\/ckj\/sfac167"},{"key":"e_1_2_9_74_1","doi-asserted-by":"crossref","DOI":"10.1177\/20543581211067087","article-title":"Clinical Outcomes With Medium Cut\u2010Off Versus High\u2010Flux Hemodialysis Membranes: A Systematic Review and Meta\u2010Analysis","volume":"9","author":"Kandi M.","year":"2022","journal-title":"Canadian Journal of Kidney Health and Disease"},{"key":"e_1_2_9_75_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ekir.2020.11.009"},{"key":"e_1_2_9_76_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.ajkd.2016.08.030"},{"key":"e_1_2_9_77_1","doi-asserted-by":"publisher","DOI":"10.1053\/ajkd.1998.v31.pm9631844"},{"issue":"1","key":"e_1_2_9_78_1","article-title":"Anticoagulation for People Receiving Long\u2010Term Haemodialysis","volume":"1","author":"Natale P.","year":"2024","journal-title":"Cochrane Database of Systematic Reviews"},{"issue":"3","key":"e_1_2_9_79_1","first-page":"135","article-title":"Anticoagulation With Nafamostat Mesilate, a Synthetic Protease Inhibitor, in Hemodialysis Patients With a Bleeding Risk","volume":"23","author":"Matsuo T.","year":"1993","journal-title":"Haemostasis"},{"key":"e_1_2_9_80_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1525-139X.2010.00770.x"},{"key":"e_1_2_9_81_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12882-017-0596-4"},{"key":"e_1_2_9_82_1","doi-asserted-by":"publisher","DOI":"10.1093\/ndt\/gfv349"},{"key":"e_1_2_9_83_1","doi-asserted-by":"publisher","DOI":"10.2215\/CJN.0000000000000461"},{"key":"e_1_2_9_84_1","doi-asserted-by":"publisher","DOI":"10.1159\/000375287"},{"key":"e_1_2_9_85_1","doi-asserted-by":"publisher","DOI":"10.1111\/aor.13700"},{"key":"e_1_2_9_86_1","doi-asserted-by":"publisher","DOI":"10.1111\/1744-9987.13440"},{"key":"e_1_2_9_87_1","doi-asserted-by":"publisher","DOI":"10.1159\/000450635"},{"key":"e_1_2_9_88_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.atherosclerosis.2021.01.018"},{"key":"e_1_2_9_89_1","doi-asserted-by":"publisher","DOI":"10.1681\/ASN.2005020132"},{"key":"e_1_2_9_90_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12882-023-03191-5"},{"key":"e_1_2_9_91_1","doi-asserted-by":"publisher","DOI":"10.3389\/fmed.2017.00073"},{"key":"e_1_2_9_92_1","doi-asserted-by":"publisher","DOI":"10.1080\/0886022X.2025.2512403"},{"key":"e_1_2_9_93_1","doi-asserted-by":"publisher","DOI":"10.4236\/jbm.2023.113011"},{"key":"e_1_2_9_94_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10047-022-01379-4"},{"key":"e_1_2_9_95_1","doi-asserted-by":"publisher","DOI":"10.3390\/bioengineering10020145"},{"key":"e_1_2_9_96_1","doi-asserted-by":"publisher","DOI":"10.1111\/sdi.12966"},{"key":"e_1_2_9_97_1","doi-asserted-by":"publisher","DOI":"10.1111\/sdi.13070"},{"key":"e_1_2_9_98_1","doi-asserted-by":"publisher","DOI":"10.1159\/000346358"}],"container-title":["Seminars in Dialysis"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/sdi.70018","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/sdi.70018","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/sdi.70018","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,3]],"date-time":"2026-05-03T02:50:02Z","timestamp":1777776602000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/sdi.70018"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,1]]},"references-count":97,"journal-issue":{"issue":"1-2","published-print":{"date-parts":[[2026,1]]}},"alternative-id":["10.1111\/sdi.70018"],"URL":"https:\/\/doi.org\/10.1111\/sdi.70018","archive":["Portico"],"relation":{},"ISSN":["0894-0959","1525-139X"],"issn-type":[{"value":"0894-0959","type":"print"},{"value":"1525-139X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,1]]},"assertion":[{"value":"2025-11-27","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-02-08","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-02-22","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}