Abstract: TH-OR052
Hemodiafiltration Is Associated with Reduced Risk of Cardiovascular and Fluid-Related Hospitalization Outcomes
Session Information
- Hemodialysis: Novel Interventions
November 06, 2025 | Location: Room 351D, Convention Center
Abstract Time: 05:30 PM - 05:40 PM
Category: Dialysis
- 801 Dialysis: Hemodialysis and Frequent Dialysis
Authors
- Zhang, Yan, Renal Research Institute, New York, New York, United States
- Winter, Anke, Renal Research Institute, New York, New York, United States
- Ficociello, Linda, Renal Research Institute, New York, New York, United States
- Carioni, Paola, Renal Research Institute, New York, New York, United States
- Arkossy, Otto, Fresenius Medical Care Deutschland GmbH, Bad Homburg, HE, Germany
- Anger, Michael S., Fresenius Medical Care Holdings Inc, Waltham, Massachusetts, United States
- Kossmann, Robert J., Fresenius Medical Care Holdings Inc, Waltham, Massachusetts, United States
- Usvyat, Len A., Renal Research Institute, New York, New York, United States
- Stuard, Stefano, Fresenius Medical Care Italia SpA, Palazzo Pignano, Lombardia, Italy
Background
Evidence from clinical trials and real-world data suggests that hemodiafiltration (HDF) is associated with reduced cardiovascular disease (CVD) mortality risk among hemodialysis (HD) patients. This study assessed the association between HDF and CVD-related hospitalization outcomes.
Methods
We conducted a retrospective cohort study among 71,669 dialysis patients treated with HDF or high-flux HD between 2019 and 2022 in Fresenius Medical Care NephroCare Clinics. CVD- and fluid-related hospitalizations were defined based on ICD-10 codes. The number of hospital admissions and hospital days were calculated for HDF and HD patients (defined by predominant modality type during follow-up [≥75%]). Incident rate ratios (IRRs) were estimated by negative binomial regression, and inverse probability of treatment weighting (IPTW) was applied to adjusted for potential confounders.
Results
During a median follow-up of 22.6 months, HDF was associated with a significantly lower CVD-related hospital admission rate compared to HD (3.09 vs. 4.23 admissions/10 person-years; IRR [95%CI]: 0.73 [0.70−0.75]; Figure 1). CVD-related hospital days were also significantly reduced in the HDF group (29 vs. 35 days/ 10 person-years; IRR [95%CI], 0.75 [0.72−0.79]). Even stronger associations were seen for fluid-related hospital admissions and hospital days (IRR [95%CI], 0.60 [0.56−0.65] and 0.64 [0.58−0.71], respectively).
Conclusion
In this large, unselected dialysis patient population treated in real-world settings, HDF was inversely associated with CVD- and fluid-related hospitalization outcomes, with reduced risks ranging between 25% and 40%. Our findings underscore the potential of HDF to improve dialysis patient outcomes and reduce the burden on healthcare systems.