Backfiltration: past, present and future

Abstract

Backfiltration has been recognized to be present in most diffusive-convective therapies. Although initially considered an inconvenience due to its implications in transport of contaminants in dialysate to the blood compartment, the availability of ultrapure dialysate has prompted a fresh look at the phenomenon of backfiltration with the possibility of exploiting it to further enhance the convective clearance of middle and large molecules. This review discusses the historical aspects of backfiltration, its mechanisms and influencing factors, and subsequently the different hemodialysis techniques in relation to increasing or diminishing this phenomenon.