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Hemodiafiltration versus conventional hemodialysis: Should "conventional" be redefined?
1Department of Nephrology, Hospital Clínic Barcelona, Barcelona, Spain.
Seminars in Dialysis
|May 30, 2018
Summary
On-line hemodiafiltration (HDF) is now a feasible and safe standard for chronic kidney disease patients, offering superior outcomes compared to conventional hemodialysis.
Area of Science:
- Nephrology
- Renal Replacement Therapy
Background:
- Conventional hemodialysis evolved significantly from the 1980s to the 1990s with technological advancements.
- Early limitations in hemodialysis included acetate dialysate, lack of volumetric control, low blood flow, and low-flux dialyzers.
Purpose of the Study:
- To evaluate if on-line hemodiafiltration (HDF) can be considered the standard conventional treatment for chronic hemodialysis patients.
- To review the evidence supporting HDF's efficacy and safety after over two decades of clinical use.
Main Methods:
- Review of clinical experience and technological developments in on-line HDF.
- Analysis of published literature on HDF versus conventional hemodialysis.
Main Results:
- On-line HDF is now technologically feasible due to advances in water treatment, dialysis machines, and high-flux dialyzers.
- No published literature indicates undesirable effects from on-line HDF.
- Scientific evidence demonstrates HDF's superiority over hemodialysis in reducing overall and cardiovascular mortality.
Conclusions:
- On-line HDF should be considered the conventional treatment for chronic hemodialysis.
- HDF offers improved patient outcomes and safety compared to traditional hemodialysis.