Hemodiafiltration in the pediatric population

Zan, Francesca De; Schmitt, Claus Peter; Shroff, Rukshana

doi:10.1111/sdi.13072

Cited by 2 publications

(1 citation statement)

References 13 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Noteworthy was the improvement in the growth curve in the HDF group compared to those on HD, which was independent of GnRH. Furthermore, an inverse correlation was observed between the growth curve and β2M levels, suggesting that removal of medium-molecular-weight molecules, including inflammatory cytokines and endogenous inhibitors of somatomedin (IGF-1) and gonadotropin, may partly alleviate growth hormone resistance in pediatric dialysis patients [ 79 ].…”

Section: Impact Of Hemodiafiltration On Clinical Outcomesmentioning

confidence: 99%

Unveiling the Clinical Benefits of High-Volume Hemodiafiltration: Optimizing the Removal of Medium-Weight Uremic Toxins and Beyond

Pedreros-Rosales,

Jara,

Lorca

et al. 2023

Toxins

View full text Add to dashboard Cite

Dialysis treatment has improved the survival of patients with kidney failure. However, the hospitalization and mortality rates remain alarmingly high, primarily due to incomplete uremic toxin elimination. High-volume hemodiafiltration (HDF) has emerged as a promising approach that significantly improves patient outcomes by effectively eliminating medium and large uremic toxins, which explains its increasing adoption, particularly in Europe and Japan. Interest in this therapy has grown following the findings of the recently published CONVINCE study, as well as the need to understand the mechanisms behind the benefits. This comprehensive review aims to enhance the scientific understanding by explaining the underlying physiological mechanisms that contribute to the positive effects of HDF in terms of short-term benefits, like hemodynamic tolerance and cardiovascular disease. Additionally, it explores the rationale behind the medium-term clinical benefits, including phosphorus removal, the modulation of inflammation and oxidative stress, anemia management, immune response modulation, nutritional effects, the mitigation of bone disorders, neuropathy relief, and amyloidosis reduction. This review also analyzes the impact of HDF on patient-reported outcomes and mortality. Considering the importance of applying personalized uremic toxin removal strategies tailored to the unique needs of each patient, high-volume HDF appears to be the most effective treatment to date for patients with renal failure. This justifies the need to prioritize its application in clinical practice, initially focusing on the groups with the greatest potential benefits and subsequently extending its use to a larger number of patients.

show abstract

Section: Impact Of Hemodiafiltration On Clinical Outcomesmentioning

confidence: 99%

Unveiling the Clinical Benefits of High-Volume Hemodiafiltration: Optimizing the Removal of Medium-Weight Uremic Toxins and Beyond

Pedreros-Rosales,

Jara,

Lorca

et al. 2023

Toxins

View full text Add to dashboard Cite

show abstract

Hemodiafiltration for children with stage 5 chronic kidney disease: technical aspects and outcomes

Ahlmann,

Stronach,

Waters

et al. 2024

Pediatr Nephrol

View full text Add to dashboard Cite

Despite significant medical and technical improvements in the field of dialysis, the morbidity and mortality among patients with chronic kidney disease (CKD) stage 5 on dialysis remains extremely high. Hemodiafiltration (HDF), a dialysis method that combines the two main principles of hemodialysis (HD) and hemofiltration—diffusion and convection—has had a positive impact on survival when delivered with a high convective dose. Improved outcomes with HDF have been attributed to the following factors: HDF removes middle molecular weight uremic toxins including inflammatory cytokines, increases hemodynamic stability, and reduces inflammation and oxidative stress compared to conventional HD. Two randomized trials in adults have shown improved survival with HDF compared to high-flux HD. A large prospective cohort study in children has shown that HDF attenuated the progression of cardiovascular disease, improved bone turnover and growth, reduced inflammation, and improved blood pressure control compared to conventional HD. Importantly, children on HDF reported fewer headaches, dizziness, and cramps; had increased physical activity; and improved school attendance compared to those on HD. In this educational review, we discuss the technical aspects of HDF and results from pediatric studies, comparing outcomes on HDF vs. conventional HD. Convective volume, the cornerstone of treatment with HDF and a key determinant of outcomes in adult randomized trials, is discussed in detail, including the practical aspects of achieving an optimal convective volume.

show abstract

Hemodiafiltration in the pediatric population

Cited by 2 publications

References 13 publications

Unveiling the Clinical Benefits of High-Volume Hemodiafiltration: Optimizing the Removal of Medium-Weight Uremic Toxins and Beyond

Unveiling the Clinical Benefits of High-Volume Hemodiafiltration: Optimizing the Removal of Medium-Weight Uremic Toxins and Beyond

Hemodiafiltration for children with stage 5 chronic kidney disease: technical aspects and outcomes

Contact Info

Product

Resources

About