Abstract

CANAUD, Bernard; SCATIZZI, Laura; GRASSMANN, Aileen  and  MARCELLI, Daniele. Haemodiafiltration: Present time technical, clinical, and financial issues. Port J Nephrol Hypert [online]. 2015, vol.29, n.2, pp.108-112. ISSN 0872-0169.

Online haemodiafiltration (HDF) is not a generic term that covers all convection-based renal replacement modalities - an optimal convection dose must be delivered to improve outcomes of end-stage kidney disease patients. In this brief article, we review current facts on HDF technical features, clinical/biological effects, and financial issues. In summary, HDF today offers highly efficient solute removal over the to-date widest known uraemic toxin molecular weight spectrum. Both safety and efficacy have been demonstrated in several short- and medium-term clinical studies. Recent randomized controled clinical trials and systematic reviews accredited the superiority of online HDF over standard haemodialysis (HD) when adequate convection dose is delivered. Additional clinical trials are needed to establish the optimal convection dose for different clinical settings (e.g. different patient characteristics and/or ethnicities, different substitution fluid delivery modalities) and to establish the cost-effectiveness of HDF compared to standard HD

Keywords : Chronic kidney disease; convective dose; end-stage kidney disease; patient outcomes; renal replacement therapy.

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