Effect of online hemodiafiltration on morbidity and mortality of chronic kidney disease patients.
Conventional diffusion-based dialysis modalities including high-flux hemodialysis (HD) are limited in their capacity to clear uremic toxins. Moreover they are associated with a relatively high incidence of morbidity and mortality. Online hemodiafiltration (ol-HDF) combining the use of a high-flux membrane dialyzer, ultrapure dialysis fluid and high convective fluid exchange is highly efficient with the lowest bioreactive profile in renal replacement therapy methods. Regular use of high-efficiency ol-HDF is associated with reduced morbidity (hypotension incidence, better blood pressure control, improved hemocompatibility, reduced inflammation profile, improved lipid profile, improved anemia correction, reduced incidence of beta2-microglobulin amyloidosis and hospitalization). More recently, several cohort studies have shown that high-efficiency ol-HDF is associated with a 35% reduced risk of mortality in an unselected dialysis population. ol-HDF has been proven to be a safe and very efficient renal replacement therapy. ol-HDF has come of age and should be considered now as the new standard for highly efficient renal replacement therapy.
Nephrology, Dialysis and Intensive Care Unit, Aider and Renal Research and Training Institute, Lapeyronie University Hospital, Montpellier, France.
Bernard
B
Canaud
D017583:Hemodiafiltration / Q000379:methods* / Q000592:standards*; D006801:Humans; D007676:Kidney Failure, Chronic / Q000150:complications* / Q000401:mortality / Q000628:therapy*; D009017:Morbidity; D009862:Online Systems; D015996:Survival Rate