Hemodialysis (HD) treatment had, over many years, improved the survival rate of patients with end-stage renal
disease. However, standard or conventional HD prescription is far from being optimal in replacing the function
of normal kidneys. Its unphysiologic clearance pattern and inability to remove all types and sizes of uremic
and mortality. Efficiency of HD can be improved by increasing blood and dialysate flow rates, dialyzer size
and surface area and duration and frequency of dialysis sessions. Home HD, where short daily or long slow
nocturnal HD sessions can conveniently be performed, provides an excellent option for quality of life improvement
and reduction in morbidity and mortality. Recent innovations in the specifications of HD machines and
improvement in dialysis membranes characteristics and water treatment technology paved the way
for achieving quality HD. These advancements have resulted in efficient implementation of adsorption, diffusion
and/or convection principles using adsorption HD, hemofiltration, hemodiafiltration (HDF) and online HDF
modalities in order to achieve optimum HD. Implementation of these innovations resulted in better quality
care achievements in clinical practice and reduction in morbidity and mortality rates among HD patients.
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