Discovery and Relative Importance of Continuous Arteriovenous HemofIltration Lee W. Henderson Continuous arteriovenous hemofiltration (CAVH) has seen a brisk upswing in popularity in Europe since its introduction by Dr. Kramer and colleagues from Gottingen, West Germany in 1977 [1]. In the United States, the technique re ceived approval as a clinical tool from the Food and Drug Administration in April 1982. This approval flowed, in no small measure, from the extensive expe rience reported from Europe and in particular West Germany [e. g., 2, 3]. Reports of its clinical utility now have begun to appear in the United States [4]. Removal of excess total body water using synthetic membranes in an extracor poreal circuit dates back to the work of Alwall and the artificial kidney that he designed which permitted utilization of a hydrostatic pressure gradient to moti vate water flow across the membrane [5]. Kolffs original rotating drum with its unencased membrane required an osmotic driving force [6]. Hemofiltration, the use of the filtration process to remove uremic solutes with the artificial kidney, in analogy with the glomerulus, was reported in 1967 [7]. This was made possible by the availability of synthetic membranes with far higher hydraulic permeability (approximately 10 times higher) than conventionally used cellulosic hemodialysis membrane. Specific applications of these "high flux" membranes to the removal primarily of excess total body water followed shortly thereafter [8].

More than 50 years after Haas' first human dialysis, and second edition by incorporating chapters on its history 40 years after Kolfrs pioneering work, a book on the and on the practical aspects. present state of the art cannot be written by one person: The size of the book has almost doubled, partly by obviously it had to be a multi-authored volume. There using more illustrations. The inclusion of a number of fore some overlap between chapters and even a few con colour reproductions has been made possible by a sup troversies between authors became unavoidable. porting grant * of the National Kidney Foundation of we deliberately avoided editorial streamlin the Netherlands, which the editors gratefully acknow However ing of manuscripts, leaving the authors' personal style ledge. We considered asking several authors to shorten their and personal opinions unaltered as much as possible. We resisted this as it would have delayed the This may make the book more vivid to read and may chapters. sometimes stimulate readers to study a subject in greater publishing date and would possibly have removed much detail from the literature. Additionally, both British and material besides being a painful task for our collea American spellings have been kept because of the inter gues.

Continuous Renal Replacement Therapy provides concise, evidence-based, bedside guidance for the management of critically ill patients with acute renal failure, offering quick reference answers to clinicians' questions about treatments and situations encountered in daily practice.

We are pleased to present our readers the Proceedings of the International Symposium "New Perspectives in Hemodialysis, Peritoneal Dialysis, Arteriovenous Hemofiltration, and Plasma pheresis" which was held in Freiburg i. Br. (FRG) during Oct tober 6-8, 1988. The meeting was held on the occasion of opening the new dialysis unit of the University Hospital of Freiburg i. Br .. The topics discussed included membrane biocompatibility, catabolic factors associated with dialysis therapy, phar macological therapy in dialyzed patients, erythropoietin and renal anemia, new developments in CAVH, CAPD and plasmapheresis, renal replacement therapy in acute renal failure, and plasmapheresis therapy in systemic diseases. It was unfortunately impossible in this volume, to include the extended, lively and stimulating discussions which were enjoyed by the participants during the conference. The meeting has provided an unique framework for close interaction between scientists from various disciplines, including nephrology, pharmacology, hematology, cardiology, anesthesiology, surgery, intensive care medicine, and patho logy. We would like to express our gratitude and appreciation for all those who have stimulated, encouraged and supported us to hold the symposium in Freiburg. This endeaver could not have been possible without the generous financial support of Asid-Bonz (BOblingen), Bayer AG (Leverkusen), Bayropharm GmbH (Koln), Baxter (Munchen), Ciba-Geigy (Wehr/Baden), Cilag GmbH (Sulzbach), Fresenius AG (Oberursel), Gambro (Martinsried), Gry Pharma GmbH (Kirchzarten), Hoechst AG (Frankfurt), Hospal (Nurnberg), Knoll AG (Ludwigshafen), Lederle-Cyanamid (Wolfratshausen), E. Merck (Darmstadt), MSD Sharp and Dohme GmbH (Munchen), Pfizer GmbH (Karlsruhe), and pfrimmer and Co (Erlangen) ."