Clinical Expectation of Online Hemodiafiltration: A Japanese Perspective

Abstract

Many pieces of evidence of online hemodiafiltration (HDF) have been reported, and the clinical advantage of postdilution online HDF with sufficient substitution is now established. After the approval of online HDF in 2012, the number of online HDF patients has been dramatically increasing in Japan and reached 10% of the total dialysis population at the end of 2013. One of the marked characteristics of Japanese online HDF is a widespread use of predilution treatment and, in 2013, 90.8% of online HDFs were carried out with the predilution mode. The main reason for the wide use of predilution online HDF results from the low blood flow rate in Japan, by which it is difficult to substitute a sufficient volume during the limited treatment time. Other reasons to choose the predilution mode include the reduction of albumin loss and the suppression of membrane fouling during treatment. Contrary to postdilution treatment, adequate clinical evidence has not been reported for predilution online HDF to provide a better outcome of the patients. A further clinical trial is expected to elucidate the clinical advantages over conventional hemodialysis for predilution online HDF.

Multicentre cross‐sectional study for bone‐articular lesions associated with dialysis related amyloidosis in Japan

“…We suspect that the institutions that have patients with longer‐term dialysis vintages more readily responded to the questionnaires. The modality rates of HDF; 3.7% or HD + PD; 2.3% were less compared with recent Japanese statistical data 10% of HDF and 4% of PD. This reason also might be derived from institutions bias.…”

Effect of online hemodiafiltration compared with hemodialysis on quality of life in patients with ESRD: A systematic review and meta-analysis of randomized trials

“…OL-HDF was officially approved for the treatment of ESRD patients and for reimbursement by the Japanese health insurance system in 2012. Thereafter, the number of OL-HDF patients in this country has been dramatically increasing [ 10 ].…”

Seven-year Survival Rate of On-line Hemodiafiltration

“…In our study, the blood flow rate was adjusted to have an average of 250 mL/min. On-line HDF mode was selected for pre-dilution hemodiafiltration due to its previously described advantages (Tiranathanagul et al, 2011;Maduell, 2015;Albalate Ramón et al, 2015;Akizawa and Koiwa, 2015).…”