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Hemodiafiltration to Address Unmet Medical Needs ESKD Patients
Bernard Canaud1,2, Jörg Vienken3, Stephen Ash4,5,6
1Center of Excellence Medical, Fresenius Medical Care, Bad Homburg, Germany.
Summary
Online hemodiafiltration enhances solute removal and patient survival compared to standard hemodialysis. This advanced therapy uses online-filtered fluid for greater efficacy in treating kidney disease patients.
Area of Science:
- Nephrology
- Renal Replacement Therapy
Background:
- Hemodiafiltration (HDF) integrates diffusive and convective solute removal.
- It requires ultrafiltration of blood and infusion of sterile replacement fluid.
- Online HDF generates large fluid volumes via filtered dialysate.
Purpose of the Study:
- To evaluate the efficacy and outcomes of online hemodiafiltration.
- To compare online HDF with conventional high-flux hemodialysis.
Main Methods:
- Utilizing high-flux hemodialyzers for >20% blood volume ultrafiltration.
- Employing online filtration of dialysate for replacement fluid.
- Implementing advanced dialysis machines for fluid balance control.
Main Results:
- Online HDF demonstrates superior removal of high molecular weight uremic solutes.
- Randomized trials suggest improved patient survival with high-volume online HDF.
- Associated with reduced intradialytic hypotension.
Conclusions:
- Online hemodiafiltration offers enhanced solute clearance and clinical benefits.
- Evidence suggests improved survival rates compared to standard hemodialysis.
- Currently treats over 100,000 patients globally, primarily in Europe and Japan.
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