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Kidney Week

Abstract: TH-PO292

Does Online Hemodiafiltration Improve Clinical Outcomes and Quality of Life in Dialysis Patients Compared to Conventional Hemodialysis?

Session Information

Category: Dialysis

  • 801 Dialysis: Hemodialysis and Frequent Dialysis

Authors

  • Khullar, Dinesh, Max Super Speciality Hospital, Dehli, India
  • Patil, Sudip, Max Super Speciality Hospital, Dehli, India
  • Grover, Rahul, Max Super Speciality Hospital, Dehli, India
  • Chhabra, Gagan, Max Super Speciality Hospital, Dehli, India
  • Bagai, Sahil, Max Super Speciality Hospital, Dehli, India
  • Singh, Prof Narinder Pal, Max Super Speciality Hospital, Dehli, India
  • Gupta, Anish Kumar, Max Super Speciality Hospital, Dehli, India
Background

The field of dialytic renal replacement modalities has seen advancements; however, interventional studies have produced dismal outcomes. The debate regarding the most beneficial outcome between hemodiafiltration (OL-HDF) and hemodialysis (HD) for dialysis patients remains open. This study aimed to compare clinical, biochemical, and quality of life (QoL) data between patients receiving HD and OL-HDF over a six-month follow-up period.

Methods

A prospective observational study was conducted involving 70 dialysis patients. The inclusion criteria included stable patients with a dialysis Kt/Vurea greater than 1.2 who had received either HDF or HD three times per week for at least three months. Patients who had undergone renal transplantation, exhibited severe noncompliance, or had a life expectancy of less than three months due to conditions unrelated to kidney illness were excluded. QoL was assessed using the dialysis symptom score over the six-month period, along with clinical and biochemical parameters. Both modalities had an intended HD treatment duration of 240 minutes, with a blood flow rate between 250-400 mL/min and a dialysate flow rate of 500 mL/min for both groups.

Results

Out of the 70 dialysis patients, 35 (19 males) were in the HD group, with an average age of 50.05±15.31 (range 41-60) years, and 35 (19 males) were in the OL-HDF group, with an average age of 50.31±11.44 years. Compared to the HD group, the HDF group showed significantly lower levels of inflammatory markers such as Beta 2-microglobulin (p < 0.001) and hs-CRP (p < 0.002), lower levels of phosphorus (p < 0.001), and higher hemoglobin (p < 0.001) over the six-month follow-up period. Patients in the HD group had higher mean symptom severity scores compared to those in the HDF group (40.97±12.24 vs. 24.11±5.03, p < 0.001). Single pool dialysis Kt/V, calcium, blood pressure control, and the amount of anti-hypertensive drugs required were similar in both groups.

Conclusion

Online hemodiafiltration may be a preferable option over conventional HD due to reduced inflammation, improved anemia control, better phosphorus control, and improved dialysis tolerance with fewer symptoms. Further research is needed to determine the long-term effects of mortality and morbidity in dialysis.