Abstract: FR-PO0509
BRIGHT HD Brazil Research Investigation on Public Health Gain Comparing Survival Between Hemodialysis and Hemodiafiltration
Session Information
- Dialysis: Hemodiafiltration, Ultrafiltration, Profiling, and Interdialytic Symptoms
November 07, 2025 | Location: Exhibit Hall, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Dialysis
- 801 Dialysis: Hemodialysis and Frequent Dialysis
Authors
- Luciano, Eduardo De paiva, Splendore Kidney Care, São Paulo, Brazil
- Borges, Cynthia Moura, Splendore Kidney Care, São Paulo, Brazil
- Cordeiro, Aline, Nefrostar Kidney Care, Campos do Jordão, SP, Brazil
- Reis, Sandra, Nefrostar Kidney Care, Campos do Jordão, SP, Brazil
- Andrade, Douglas Vega, Núcleo de Saúde FLMA/IRSSL, Campos do Jordão, SP, Brazil
- Rocha, Whelington Figueiredo, Nefrostar Kidney Care, Campos do Jordão, SP, Brazil
- Magalhães, Andréa Olivares, Nefrostar Kidney Care, Campos do Jordão, SP, Brazil
- Elias, Rosilene M., Splendore Kidney Care, São Paulo, Brazil
Background
High-flux online hemodiafiltration (OL-HDF) appears to be associated with better survival than hemodialysis (HD). In Brazil, OL-HDF is only affordable for patients with private health insurance. Although observational studies have shown a survival advantage with OL-HDF, even in Brazil, it is unclear whether this benefit applies to patients without private health insurance. We compared overall and cardiovascular mortality between OL-HDF and HD in patients treated exclusively through the Public Health Care system.
Methods
This is an observational cohort study with adult patients on maintenance hemodialysis or OL-HDF in the study period between September 1, 2022, and December 1, 2024.
The primary outcome was all-cause mortality. The secondary outcome was cardiovascular mortality.
Results
Patients on HD were more likely to have diabetes (54.0% vs 29.2%, p 0.001) and spent more hours per week on dialysis (11.2 ± 1.8 vs. 10.5 ± 1.6 hours, p=0.006). In an adjusted Fine-Gray model, the hazard of death for patients on OL-HDF was 68% lower than that for patients on HD, and the risk of death for patients with an arteriovenous fistula was 55% lower compared to those with a catheter. Cardiovascular mortality did not differ between the groups.
Conclusion
These findings suggest that OL-HDF is associated with higher overall survival compared to HD, even for patients without private health insurance.