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Review
. 2018 Oct 1;33(suppl_3):iii53-iii58.
doi: 10.1093/ndt/gfy218.

Clinical evidence on haemodiafiltration

Peter J Blankestijn  1 , Muriel P Grooteman  2 , Menso J Nube  2 , Michiel L Bots  3
Affiliations
Review

Clinical evidence on haemodiafiltration

Peter J Blankestijn et al. Nephrol Dial Transplant. .

Abstract

Haemodiafiltration (HDF) combines diffusive and convective solute removal in a single treatment session. HDF provides a greater removal of higher molecular weight uraemic retention solutes than conventional high-flux haemodialysis (HD). Recently completed randomized clinical trials suggest better patient survival with online HDF. The treatment is mainly used in Europe and Japan. This review gives a brief overview of the presently available evidence of the effects of HDF on clinical end points, it speculates on possible mechanisms of a beneficial effect of HDF as compared with standard HD and ends with some perspectives for the future.

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Figures

FIGURE 1
FIGURE 1
Annualized CVD mortality per 100 patient-years in the HD and online HDF groups. The numbers in the boxes represent fatal CVD events/100 patient-years. The difference in fatal cardiac events between HD and HDF is significant (P = 0.01). Reprinted from Nubé et al. [14].
See this image and copyright information in PMC

References

    1. Grooteman MP, van den Dorpel MA, Bots ML. et al. Effect of online hemodiafiltration on all-cause mortality and cardiovascular outcomes. J Am Soc Nephrol 2012; 23: 1087–1096 - PMC - PubMed
    1. Ok E, Asci G, Toz H. et al. Mortality and cardiovascular events in online haemodiafiltration (OL-HDF) compared with high-flux dialysis: results from the Turkish OL-HDF Study. Nephrol Dial Transplant 2013; 28: 192–202 - PubMed
    1. Maduell F, Moreso F, Pons M. et al. High-efficiency postdilution online hemodiafiltration reduces all-cause mortality in hemodialysis patients. J Am Soc Nephrol 2013; 24: 487–497 - PMC - PubMed
    1. Morena M, Jaussent A, Chalabi L. et al. Treatment tolerance and patient-reported outcomes favor online hemodiafiltration compared to high-flux hemodialysis in the elderly. Kidney Int 2017; 91: 1495–1509 - PubMed
    1. Mostovaya IM, Blankestijn PJ, Bots ML. et al. Clinical evidence on hemodiafiltration: a systematic review and a meta-analysis. Semin Dial 2014; 27: 119–127 - PubMed

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