The use of high-dose hemodiafiltration resulted in a lower risk of death from any cause than conventional high-flux hemodialysis in kidney failure patients.
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‘In Patients with kidney failure resulting in kidney-replacement therapy, high-dose hemodiafiltration may be more beneficial than standard hemodialysis. #kidney failure #dialysis #Kidney transplant’
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Chronic kidney disease is a leading global health problem that affects an estimated 830 million people globally. When the kidneys can no longer do their job, dialysis is used to clean the blood by removing waste products, a function normally performed by the kidneys themselves. Around four million people are on dialysis worldwide.
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Haemodialysis (1✔ ✔Trusted Source
Recent advances in treatment of haemodialysis
Go to source) is the most common form of dialysis used in the treatment of kidney failure. Though it has improved over the years, it is not good at removing larger molecules from the blood.
Haemodiafiltration Can Become the New Standard for Kidney Transplant
Haemodiafiltration is a newer technology that can remove larger molecules, but it is not suitable for all patients since it requires a higher blood flow rate to be effective. Previous studies have failed to conclusively prove that one method is more effective than the other (2✔ ✔Trusted SourceEffect of Hemodiafiltration or Hemodialysis on Mortality in Kidney Failure
Go to source).
The CONVINCE trial has been led by researchers at UMC Utrecht together with collaborators at University College London (UCL), Charité Universitätsmedizin Berlin, University of Bari, The George Institute for Global Health and Imperial College London, along with dialysis providers Fresenius Medical Care, Diaverum and B. Braun Avitum.
At 61 centers in eight European countries, a total of 1,360 patients were randomized, with 683 treated with high-dose haemodiafiltration and 677 treated with high-flux hemodialysis three times a week.
During a median follow-up of 30 months, all-cause mortality was 21.9% among those treated with high-flux hemodialysis, compared to 17.3% for those treated with high-volume haemodiafiltration. This 4.6% difference represents a 23% reduction in the risk of death.
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While hemodialysis is a standard treatment in most countries, haemodiafiltration is less widely used in some places and is not used at all in places like the US (3✔ ✔Trusted Source
Global prevalent use, trends and practices in haemodiafiltration
Go to source). Most modern dialysis machines can perform either method, which would make a switch to haemodiafiltration relatively easy.
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This study proves that targeting different molecules through haemodiafiltration has clear benefits for patients. This is the first major step forward in many years and is good news for kidney disease patients and their families.
References:
- Recent advances in treatment of haemodialysis - (https://journals.sagepub.com/doi/10.1177/0141076820972669)
- Effect of Hemodiafiltration or Hemodialysis on Mortality in Kidney Failure - (https://www.nejm.org/doi/10.1056/NEJMoa2304820)
- Global prevalent use, trends and practices in haemodiafiltration - (https://academic.oup.com/ndt/article/35/3/398/5320340?login=false)
Source-Eurekalert