Progrès réalisés et à venir de l'hémodialyse intermittente

The intermittent hemodialysis (IHD) is the oldest mode of renal replacement therapy (RRT). Its advantages, its performances and its disadvantages are well-known. The objectives of accomplished and future progress are to improve the quality of filtration process, better hemodynamic tolerance of IHD and forecast of acute renal failure (ARF). Among technical progress, sodium enriched dialysate and use of bicarbonate buffer, have been improving hemodynamic status during hemodialysis. The biocompatibility of the synthetic membranes seems to offer benefit in terms of reduced mortality. Among the new modalities of use of IHD, the earliness and the intensity of dialysis could ameliorate the prognosis while the sustained low-efficiency dialysis (SLED) and the monitoring of plasmatic volume during profiling hemodialysis ameliorate the hemodynamic stability of IHD. Knowledge and better control of this progress should be widespread for an optimal use of IHD technology.