title: [Hemodiafiltration compared to hemodialysis regarding all-cause mortality and quality of life: a systematic review].
abstract: BACKGROUND
  Patients with end-stage renal disease are dependent on chronic renal replacement therapy. Outcomes regarding the clinical benefits of hemodiafiltration (HDF) compared to hemodialysis (HD) have been inconclusive so far. The aim of this systematic review is to evaluate the effect of HDF on all-cause mortality and quality of life compared to HD.
  
  
  METHODS
  A systematic review of published literature was conducted using two bibliographic databases and two trial registers. The review was conducted in September and October 2013.
  
  
  RESULTS
  The search yielded 14 relevant studies. Out of 3 large randomized controlled trials reporting the outcome mortality, 1 reported a significantly lower mortality in the HDF-arm; the other 2 did not show significant differences between arms. 1 large randomized controlled trial reporting the outcome quality-of-life was identified, no significant differences were reported. The remaining body of evidence was assessed as non-robust.
  
  
  CONCLUSIONS
  A positive influence of HDF on overall survival appears probable if high-volume fluid exchange is achieved. Only one large randomized controlled trial reports significantly lower overall mortality after treatment with HDF for all patients. There is no reliable evidence for better quality-of-life after treatment with HDF.
authors.affiliation: Fachgebiet Management im Gesundheitswesen, Technische Universität Berlin.
authors.forename: D
authors.initials: D
authors.lastname: Panteli
authors.affiliation: Fachgebiet Management im Gesundheitswesen, Technische Universität Berlin.
authors.forename: F
authors.initials: F
authors.lastname: Wittenbecher
authors.affiliation: Fachgebiet Management im Gesundheitswesen, Technische Universität Berlin.
authors.forename: R
authors.initials: R
authors.lastname: Busse
mesh_terms: D002423:Cause of Death; D017583:Hemodiafiltration / Q000401:mortality*; D006801:Humans; D007676:Kidney Failure, Chronic / Q000523:psychology* / Q000628:therapy*; D011788:Quality of Life; D006435:Renal Dialysis / Q000401:mortality*