Comparison of Solute Clearance, Hospitalization Rate, and Aortic Arch Calcification between Online Hemodiafiltration and High-Flux Hemodialysis: A 6-Year Observational Study

Abstract

Background/Aims: Studies on the long-term clinical benefits of hemodiafiltration (HDF) and high-flux hemodialysis (HFHD) are very limited. This study aimed to investigate the hospitalization rate and aortic arch calcification (AAC) of these two dialysis modalities over 6 years. Methods: Participants who received regular HDF and HFHD in one hospital-facilitated hemodialysis center were prospectively enrolled after matching for age, sex, and diabetes between January 2009 and December 2014. Medical records were reviewed retrospectively on demographics, laboratory variables, calcified scores in aortic arch measured by chest radiography, and rates of hospital admission. Cox proportional hazard regression and linear regression were used to obtain the outcome results. Results: The HDF and HFHD groups consisted of 108 and 102 participants, respectively. Levels of laboratory variables including small soluble solutes and Kt/V were not statistically different over the 6-year period between the HDF and HFHD groups. Calcified scores of the aortic arch increased over 6 years in both groups. The changes in the mean calcified scores were significant when compared between the two groups (0.44–1.82 in HFHD, 0.79–1.8 in HDF, respectively, p = 0.008). Hospitalization rates were 735 per 1,000 patients in the HDF group and 852 per 1,000 patients in the HFHD group, respectively. No significant difference was observed in frequency and days of hospitalization between HDF and HFHD. Conclusion: Hospitalization rates and AAC were observed to be equal for HDF and HFHD.

Effect of Dialysis Modality on Bone Disease in Patient with End Stage Renal Disease

“…On the other hand there was no significant difference between both groups as regard serum creatinine, sodium and potassium levels, which agrees with Hao et al (12) , who showed no significant difference between high flux dialysis and online HDF after 6 years.…”

Middle‐size molecule clearance as measured by β2‐microglobulin in high‐flux versus low‐flux dialysis and hemodiafiltration: A prospective randomized controlled trial

“…Whereas most randomized controlled trials to date have mainly concentrated on the comparison between HFHD and HDF, or HFHD and LFHD in relation to the clearance of β2M in HD patients, there have been few related to combined HFHD and HDF therapy. In a 6‐year observational study, hospitalization rates and aortic arch calcification were equal between HDF and HFHD 15 . Several recent studies on HFHD combined with HDF have focused on the association between different dialysis models and phosphorus removal 16 or serum calcification propensity 17 .…”

“…In a 6-year observational study, hospitalization rates and aortic arch calcification were equal between HDF and HFHD. 15 Several recent studies on HFHD combined with HDF have focused on the association between different dialysis models and phosphorus removal 16 or serum calcification propensity. 17 In another study, patients were switched from HFHD to HDF therapy, which did not result in significant changes in hsCRP, β2M, or ESA doses.…”