High dose hemodiafiltration may reduce mortality in kidney transplant cases: NEJM

A new study published in The New England Journal of Medicine suggests that high-dose hemodiafiltration reduced the risk of mortality from any cause in patients receiving kidney replacement treatment for renal failure compared to traditional high-flux hemodialysis.

According to several studies, high-dose hemodiafiltration may be more advantageous for individuals with renal failure than traditional hemodialysis. However, more information is required due to the shortcomings of the numerous published investigations. The purpose of this study, which was carried out by Peter Blankestijn and colleagues, was to evaluate the impact of hemodiafiltration on mortality in renal failure.

Patients with renal failure who had been receiving high-flux hemodialysis for at least three months participated in a pragmatic, randomized, international, controlled study. All of the patients met the criteria for high-dose hemodiafiltration (convection volume of at least 23 liters each session) and were able to complete patient-reported outcome evaluations. The patients were given the option of continuing with the standard high-flux hemodialysis or receiving high-dose hemodiafiltration. Death from any cause was the main result. The composite of fatal or nonfatal cardiovascular events, kidney transplantation, and repeated all-cause or infection-related hospitalizations were significant secondary outcomes.