Does Hemodiafiltration offer survival benefit over high-flux hemodialysis?

Both hemodiafiltration (HDF) and high-flux hemodialysis (HD) are renal replacement therapies used in the treatment of end-stage renal disease (ESRD). They are both forms of hemodialysis, which involves the removal of waste products and excess fluids from the blood when the kidneys are no longer able to perform these functions adequately.

Lets Understand the terminology

• Hemodiafiltration (HDF): In HDF, the dialysis process combines diffusion (as in traditional hemodialysis) with convective transport, where a fluid replacement solution is added to enhance the removal of larger-sized toxins. HDF is considered to offer better clearance of larger middle-molecule substances compared to traditional high-flux hemodialysis. Some studies suggest potential benefits in terms of long-term survival and cardiovascular outcomes with HDF compared to high-flux hemodialysis.
• High-Flux Hemodialysis (HD): High-flux hemodialysis uses a high-permeability dialyzer membrane that allows for more efficient removal of middle-molecule toxins compared to low-flux hemodialysis. It is a more advanced form of traditional hemodialysis, offering improved clearance of certain substances from the blood.