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[Online hemodiafiltration: Practical aspects, safety and efficacy].

Bernard Canaud1, Leïla Chénine2, Hélène Leray-Moraguès1

  • 1Néphrologie, dialyse et soins intensifs, hôpital Lapeyronie, CHRU de Montpellier, 375, avenue du Doyen-Giraud, 34925 Montpellier cedex 5, France; Association pour l'installation à domicile des épurations rénales (Aider), 746, rue de la Croix-de-Lavit, 34192 Montpellier, France; Institut de recherche et formation en dialyse (IRFD), hôpital Lapeyronie, CHRU de Montpellier, 375, avenue du Doyen-Giraud, 34295 Montpellier, France.

Nephrologie & Therapeutique
|May 10, 2017
PubMed
Summary

Online hemodiafiltration offers superior renal replacement therapy compared to conventional hemodialysis. This advanced treatment significantly reduces patient morbidity and mortality, establishing it as the new standard of care.

Keywords:
Chronic kidney diseaseDialyseDialysisHigh efficiency renal replacement therapyHémodiafiltration en ligneInsuffisance rénale chroniqueMortalityMortalitéOnline hemodiafiltrationSuppléance rénale de haute efficacité

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Area of Science:

  • Nephrology
  • Renal Replacement Therapy
  • Dialysis Technology

Background:

  • Conventional hemodialysis has limitations in clearing high molecular uremic toxins.
  • This inefficiency is linked to significant patient morbidity and high mortality rates.

Purpose of the Study:

  • To evaluate the efficacy and safety of online hemodiafiltration (OL-HDF) as an advanced renal replacement therapy.
  • To determine if OL-HDF can improve patient outcomes compared to conventional hemodialysis.

Main Methods:

  • Utilizing high-permeability hemodiafilters and ultrapure dialysate.
  • Maximizing substitution volumes during online hemodiafiltration treatments.
  • Analysis of prospective and randomized studies assessing clinical outcomes.

Main Results:

  • OL-HDF demonstrates high efficiency and low bio-incompatibility in renal supplementation.
  • Regular OL-HDF use is associated with reduced intradialytic hypotension, improved blood pressure control, and a better inflammatory profile.
  • Studies show OL-HDF is linked to better anemia correction, prevention of β2-microglobulin-associated amyloidosis, and significant mortality reduction.

Conclusions:

  • Online hemodiafiltration is a mature and highly effective renal replacement therapy.
  • Its proven safety and efficacy suggest it should become the new standard of care for patients requiring renal support.