Nocturnal, every-other-day, online haemodiafiltration: an effective therapeutic alternative

Maduell, Francisco; Arias, Marta; Durán, Carlos E.; Vera, Manel; Fontseré, Néstor; Azqueta, Manel; Rico, Nayra; Perez, N.; Sentís, Alexis; Elena, Montserrat; Rodríguez, Néstor; Arcal, Carola; Bergadá, E; Cases, Aleix; Bedini, José Luis; Campistol, Josep M.

doi:10.1093/ndt/gfr491

Cited by 46 publications

(51 citation statements)

References 39 publications

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“…It is unclear what value HDF could add to more frequent dialysis schedules. 13 Furthermore, published data on HDF in children are very limited. In this group of patients, a totally different endpoint, growth acceleration, could be of great relevance.…”

mentioning

confidence: 99%

Has the Time Now Come to More Widely Accept Hemodiafiltration in the United States?

Blankestijn

2013

Journal of the American Society of Nephrology

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mentioning

confidence: 99%

Has the Time Now Come to More Widely Accept Hemodiafiltration in the United States?

Blankestijn

2013

Journal of the American Society of Nephrology

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“…These two approaches, HDF and extended treatment time, should not be considered competitive but rather complementary. Only a few studies have combined the solute mass transfer capacity of HDF with increased treatment time [19][20][21] and all clinical trials have confirmed the tremendous benefits of such combination on intermediary and long-term outcomes.…”

Section: Why Is Hemodiafiltration Needed?mentioning

confidence: 99%

Update on Clinical Evidence Supporting Hemodiafiltration

Canaud¹,

Grassmann²,

Scatizzi³

et al. 2016

Advances in Hemodiafiltration

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The aim of this chapter is to define hemodiafiltration target efficiency, to clarify the concept of "optimal convective dose," and to facilitate hemodiafiltration (HDF) implementation in clinical practice by addressing the need for the establishment of best clinical practices for HDF. The approach taken was to conduct a comprehensive summary of clinical evidence supporting HDF. Convective dose is the total ultrafiltered volume and is complementary to diffusive dose (urea Kt/V) as a dose-dependent parameter. It can be quantified and adjusted to patient characteristics. Factors affecting convective dose are discussed: patient characteristics, prescription-dependent factors, and technical and machine-dependent factors. The key issue of HDF prescription and implementation of best practices is addressed as are intermediary and endpoint clinical outcomes. The main messages are as follows: (1) HDF is safe and effective provided that best clinical practices are followed and the right convective dose is delivered; (2) HDF is easy to perform with new technology; and (3) depending on the convection volume, HDF reduces all-cause and cardiovascular mortality. Open challenges remain, namely, the implementation of best practices to (a) achieve optimal convection volume, (b) define patient subsets that would benefit more from HDF, and (c) evaluate new tools that fine-tune HDF prescription according to individual patient needs.

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“…This can be achieved by avoiding the two days weekend gap and implementation of in-center every other day dialysis [11,113]. A recent study of analyzing records of 32,000 people receiving dialysis three times a week from 2005 through 2008 found a 22% greater risk of death on the day after a long break, compared with other days.…”

Section: Frequent Hemodialysismentioning

confidence: 99%

“…Hyperphosphatemia, which has been associated with vascular calcification and considered as an independent predictor of mortality in dialysis patients [132], has been well controlled with efficient removal of phosphorus by online HDF [113,129,133] with marked reduction in phosphate binders [113]. Furthermore, the reduction ratio of β 2 -M per session has been shown to be 20-30% higher with online HDF than with high-flux HD (72.7 versus 49.7%) [134].…”

Section: Online Hemodiafiltrationmentioning

confidence: 99%

“…The efficient removal of different types and sizes of uremic toxins by online HDF [138] has been associated with reduction of skin pigmentation [139], promotion of catch-up growth in children on chronic dialysis [140] and nutritional status improvement [141]. More recently, Maduell et al [113] have demonstrated a remarkable improvement in nutritional status with adequate social and occupational rehabilitation.…”

Section: Online Hemodiafiltrationmentioning

confidence: 99%

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