Most patients with end stage renal disease (ESRD) are supported with maintenance haemodialysis (HD) and this has been the case for many years. Recent improvements in water quality have led to the increased use of high-flux HD and more recently of online-haemodiafiltration (HDF). HDF has been promoted by some clinicians and by renal industry as potentially offering improved clinical and quality of life outcomes for patients over conventional HD. However, despite such benefits making theoretical sense very few studies of the use of HDF as compared to HD (especially high-flux HD) have been able to demonstrate any significant benefit for the therapy.
This article reviews the most recent research that has compared HDF and HD and has identified that the evidence for the benefit of HDF remains elusive. This article, therefore, concludes that there is currently still not sufficient evidence from the research to support the contention that HDF confers benefits to patients over conventional HD and thereby no compelling evidence to justify its widespread use as a preferred form of treatment.
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