Hemodiafiltration and clinical outcomes

Main Article Content

Chakkraphong Thedphithak
Peenida Skulratanasak

Abstract

Nowadays, the number of end stage renal disease (ESRD) patients tends to increase every year. The renal replacement therapy including hemodialysis, peritoneal dialysis and kidney transplantation demonstrates a benefit of improved quality of life and survival particularly kidney transplantation. Despite the techniques of hemodialysis have been developed in the past three decades, the all-cause mortality and cardiovascular mortality are still higher than general population. Therefore, to enhance the efficacy of uremic toxins clearance, hemodiafiltration method that combined diffusive with convective solute removal in a single therapy was developed. Recently, many clinical researches have been proven the advantages of hemodiafiltration over the conventional hemodialysis. However, the highly efficient hemodiafiltration requires the specific technique with a high-flux dialyzer, vascular access to provide the sufficient blood flow rate and ultrapure dialysate fluid. Because the adequate convection volume is the pivotal factor for decreased mortality in hemodiafiltration. This article reviews the principle of hemodiafiltration and clinical outcomes including mortality in dialysis patient, solute clearances, cardiovascular disease, and nutritional status.

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How to Cite
Thedphithak, C., & Skulratanasak, P. (2022). Hemodiafiltration and clinical outcomes. Journal of the Nephrology Society of Thailand, 28(3), 4–14. Retrieved from https://he01.tci-thaijo.org/index.php/JNST/article/view/258619
Section
Review Article

References

Canaud B, Köhler K, Sichart JM, Möller S. Global prevalent use, trends and practices in haemodiafiltration. Nephrol Dial Transplant. 2020; 35(3):398-407.

Tattersall JE, Ward RA. Online haemodiafiltration: definition, dose quantification and safety revisited. Nephrol Dial Transplant. 2013; 28(3):542-50.

Canaud B, Vienken J, Ash S, Ward RA. Hemodiafiltration to Address Unmet Medical Needs ESKD Patients. Clin J Am Soc Nephrol. 2018; 13(9):1435-43.

Tiranathanagul K, Susantitaphong P, Keomany C, Mahatanan N, Praditpornsilpa K, Eiam-Ong S. Long-term efficacy of pre- and post-dilution online hemodiafiltration with dialyzer reuse. J Med Assoc Thai. 2012; 95(5):650-6.

Maduell F. Is There an ‘Optimal Dose' of Hemodiafiltration?. Blood Purif. 2015; 40(suppl 1):17-23.

Grooteman MPC, van den Dorpel MA, Bots ML, Penne EL, van der Weerd NC, Mazairac AHA, et al. Effect of Online Hemodiafiltration on All-Cause Mortality and Cardiovascular Outcomes. J Am Soc Nephrol. 2012; 23(6):1087-96.

Ok E, Asci G, Toz H, Ok ES, Kircelli F, Yilmaz M, et al. Mortality and cardiovascular events in online haemodiafiltration (OL-HDF) compared with high-flux dialysis: results from the Turkish OL-HDF Study. Nephrol Dial Transplant. 2013; 28(1):192-202.

Maduell F, Moreso F, Pons M, Ramos R, Mora-Macià J, Carreras J, et al. High-Efficiency Postdilution Online Hemodiafiltration Reduces All-Cause Mortality in Hemodialysis Patients. J Am Soc Nephrol. 2013; 24(3):487-97.

Morena M, Jaussent A, Chalabi L, Leray-Moragues H, Chenine L, Debure A, et al. Treatment tolerance and patient-reported outcomes favor online hemodiafiltration compared to high-flux hemodialysis in the elderly. Kidney Int. 2017; 91(6):1495-509.

Peters SAE, Bots ML, Canaud B, Davenport A, Grooteman MPC, Kircelli F, et al. Haemodiafiltration and mortality in end-stage kidney disease patients: a pooled individual participant data analysis from four randomized controlled trials. Nephrol Dial Transplant. 2015; 31(6):978-84.

Davenport A, Peters SAE, Bots ML, Canaud B, Grooteman MPC, Asci G, et al. Higher convection volume exchange with online hemodiafiltration is associated with survival advantage for dialysis patients: the effect of adjustment for body size. Kidney Int. 2016; 89(1):193-9.

Neri L, Gurevich K, Zarya Y, Plavinskii S, Bellocchio F, Stuard S, et al. Practice Patterns and Outcomes of Online Hemodiafiltration: A Real-World Evidence Study in a Russian Dialysis Network. Blood Purif. 2021;50:309-18.

Schiffl H. Online hemodiafiltration and mortality risk in end-stage renal disease patients: A critical appraisal of current evidence. Kidney Res Clin Pract. 2019;38(2):159-68.

Masakane I, Kikuchi K, Kawanishi H. Evidence for the Clinical Advantages of Predilution On-Line Hemodiafiltration. Contrib Nephrol. 2017;189:17-23.

Borrelli S, Minutolo R, De Simone E, De Simone W, Provenzano M, De Nicola L, et al. Effect of Increased Convection Volume by Mid-Dilution Hemodiafiltration on the Subclinical Chronic Inflammation in Maintenance Hemodialysis Patients. Blood Purif. 2019;47(1-3):1-9.

Pedrini LA, Zawada AM, Winter AC, Pham J, Klein G, Wolf M, et al. Effects of high-volume online mixed-hemodiafiltration on anemia management in dialysis patients. PLoS One. 2019;14(2):e0212795.

Susantitaphong P, Tiranathanagul K, Katavetin P, Hanwiwatwong O, Wittayalertpanya S, Praditpornsilpa K, et al. Efficacy comparison between simple mixed-dilution and simple mid-dilution on-line hemodiafiltration techniques: a crossover study. Artif Organs. 2012; 36(12):1059-65.

Lornoy W, De Meester J, Becaus I, Billiouw JM, Van Malderen PA, Van Pottelberge M. Impact of convective flow on phosphorus removal in maintenance hemodialysis patients. J Ren Nutr. 2006;16(1):47-53.

Penne EL, van der Weerd NC, van den Dorpel MA, Grooteman MP, Lévesque R, Nubé MJ, et al. Short-term effects of online hemodiafiltration on phosphate control: a result from the randomized controlled Convective Transport Study (CONTRAST). Am J Kidney Dis. 2010;55(1):77-87.

Roumelioti ME, Trietley G, Nolin TD, Ng YH, Xu Z, Alaini A, et al. Beta-2 microglobulin clearance in high-flux dialysis and convective dialysis modalities: a meta-analysis of published studies. Nephrol Dial Transplant. 2018;33(6):1025-39.

Choo SZ, Polkinghorne KR, Kerr PG. Biochemical comparison of 8 h haemodialysis and 4 h haemodiafiltration, and two dialysis membranes, in a randomized cross-over trial. Nephrology (Carlton). 2019;24(5):542-9.

Panichi V, Rocchetti MT, Scatena A, Rosati A, Migliori M, Pizzarelli F, et al. Long term variation of serum levels of uremic toxins in patients treated by post-dilution high volume on-line hemodiafiltration in comparison to standard low-flux bicarbonate dialysis: results from the REDERT study. J Nephrol. 2017;30(4):583-91.

Vega A, Sanchez-Niño MD, Ortiz A, Abad S, Macías N, Aragoncillo I, et al. The new marker YKL-40, a molecule related to inflammation, is associated with cardiovascular events in stable haemodialysis patients. Clin Kidney J. 2019;13(2):172-8.

den Hoedt CH, van Gelder MK, Grooteman MP, Nubé MJ, Blankestijn PJ, Goldschmeding R, et al. Connective Tissue Growth Factor Is Related to All-cause Mortality in Hemodialysis Patients and Is Lowered by On-line Hemodiafiltration: Results from the Convective Transport Study. Toxins (Basel). 2019;11:268.

Martínez-Alonso E, Alcázar P, Camafeita E, Fernández-Lucas M, Ruíz-Roso G, Alcázar A. Proteomic analysis of plasma proteins of high-flux haemodialysis and on-line haemodiafiltration patients reveals differences in transthyretin levels related with anaemia. Sci Rep. 2020;10(1):16029.

Locatelli F, Carfagna F, Del Vecchio L, La Milia V. Haemodialysis or haemodiafiltration: that is the question. Nephrol Dial Transplant. 2018;33(11):1896-904.

Ethier I, Auger D, Beaulieu M, Wesolowska E, Lévesque R. Evolution of high-sensitivity troponin-T and echocardiography parameters in patients undergoing high efficiency on-line hemodiafiltration versus conventional low-flux hemodialysis. PLoS One. 2019; 14(10):e0223957.

Maduell F, Varas J, Ramos R, Martin-Malo A, Pérez-Garcia R, Berdud I, et al. Hemodiafiltration Reduces All-Cause and Cardiovascular Mortality in Incident Hemodialysis Patients: A Propensity-Matched Cohort Study. Am J Nephrol. 2017; 46(4):288-97.

Ghigolea AB, Gherman-Caprioara M, Moldovan AR. Arterial stiffness: hemodialysis versus hemodiafiltration. Clujul Med. 2017;90(2):166-70.

Lu W, Ren C, Han X, Yang X, Cao Y, Huang B. The protective effect of different dialysis types on residual renal function in patients with maintenance hemodialysis: A systematic review and meta-analysis. Medicine (Baltimore). 2018;97(37):e12325.

Molina P, Vizcaíno B, Molina MD, Beltrán S, González-Moya M, Mora A, et al. The effect of high-volume online haemodiafiltration on nutritional status and body composition: the ProtEin Stores prEservaTion (PESET) study. Nephrol Dial Transplant. 2018;33(7):1223-35.

Ashby D, Borman N, Burton J, Corbett R, Davenport A, Farrington K, et al. Renal Association Clinical Practice Guideline on Haemodialysis. BMC Nephrol. 2019;20(1):379.

คณะอนุกรรมการกำหนดแนวทางการรักษาด้วยการฟอกเลือดและการกรองพลาสมาสมาคมโรคไตแห่งประเทศไทย. คู่มือการรักษาด้วยการฟอกเลือดและการกรองพลาสมาสำหรับผู้ป่วยโรคไต. 2018.