Mechanisms Supporting the Clinical Benefits of Hemodiafiltration: A Comprehensive Review

7th International Congress of Cardionephrology KARNEF (2025) [pp. 138-158]

AUTHOR(S) / АУТОР(И): Bernard Canaud

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DOI: 10.46793/KARNEF25.144C

ABSTRACT / САЖЕТАК:

Background: Online hemodiafiltration (OHDF) is an advanced kidney replacement therapy (KRT) that enhances uremic toxin clearance and offers cardiovascular benefits over conventional high-flux hemodialysis (HD), provided that high convective volumes are achieved.

Objective: This review examines the mechanisms underlying OHDF’s clinical and benefits and how they contribute to improve patient outcomes.

Key Findings: OHDF improves vascular and cardiac health by stabilizing hemodynamics, reducing inflammation and oxidative stress, and enhancing middle- and large-molecular-weight toxin removal. Additional benefits include better anemia management, improved nutritional status, and enhanced quality of life.

Future Directions: Research should explore patient-centered kidney care, effects on subgroup of patients such as diabetic, cardiac or elderly, and its potential role in incremental and intensive dialysis.

Conclusion: OHDF is a superior dialysis modality that improves survival and patient outcomes, primarily by improving vascular and cardiac health. These benefits underscore the need for broader adoption and patient-centered optimization of OHDF.

KEYWORDS / КЉУЧНЕ РЕЧИ:

Kidney replacement therapy, Dialysis patient outcome, Cardiovascular burden, Athero-sclerosis, Uremic toxicity

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