Kidney Week

Abstract: SA-PO1064

Hemodiafiltration vs. High-Flux Hemodialysis: A Survey from the EuDial Working Group of the European Renal Association

Session Information

• Kidney Replacement Therapy and Care Delivery Innovations
  October 24, 2026 | Location: Exhibit Hall A, Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: Dialysis

• 801 Dialysis: Hemodialysis and Frequent Dialysis

Authors

• Battaglia, Yuri, Universita degli Studi di Trento, Trento, Trentino-Alto Adige/South Tyrol, Italy

Yuri Battaglia, MD, PhD

• Baciga, Federica, Ospedale P Pederzoli Casa di Cura Privata SpA, Peschiera del Garda, Veneto, Italy

Federica Baciga

• Meijers, Björn Ki, Nephrology Unit, University Hospitals Leuven, Leuven, Belgium

Björn Ki Meijers, MD, PhD

• Shroff, Rukshana, University College London, London, England, United Kingdom

Rukshana Shroff, MD, PhD

• Kazancioglu, Rumeyza, Bezmialem Vakif Universitesi, Istanbul, Turkey

Rumeyza Kazancioglu, MD

• Alfano, Gaetano, Azienda Ospedaliero-Universitaria di Modena, Modena, Emilia-Romagna, Italy

Gaetano Alfano, DrMed

• Hecking, Manfred, Medizinische Universitat Wien, Vienna, Austria

Manfred Hecking, DrMed, PhD

• Franssen, Casper F.M., Universitair Medisch Centrum Groningen Afdeling Cardiologie, Groningen, GR, Netherlands

Casper F.M. Franssen, MD, PhD

• Luyckx, Valerie A., Brigham and Women's Hospital, Boston, Massachusetts, United States

Valerie A. Luyckx, MD, MS, PhD

• Combe, Christian, Universite de Bordeaux, Talence, Nouvelle-Aquitaine, France

Christian Combe, MD, PhD

• Basile, Carlo, Ospedale di Martina Franca, Martina Franca, Apulia, Italy

Carlo Basile, MD, PhD, FASN

Group or Team Name

• EuDial Working Group of European Renal Association

Background

Post-dilution online hemodiafiltration(HDF),compared with high-flux hemodialysis(HD),is associated with improved overall and cardiovascular survival when high convective volumes are achieved.However, real-world data on modality selection and clinical practice remain limited.This study aimed to assess current practices and clinician perspectives on HDF versus high-flux HD among ordinary members of EuDial WG.

Methods

We conducted a 24-item electronic survey with questions on center characteristics,dialysis modalities and institutional protocols.Clinician preferences,perceived barriers and benefits,and awareness of a previous EuDial Consensus Statement were also collected.

Results

288 responses from 27 countries were analyzed(European n=252;non-European n=36),with 58.7% from public centers.HDF use was more frequent in Western(66.9%),Southern Europe(58.1%), and Northern Europe(56.9%)compared with Eastern Europe(47.4%)(Figure 1).Among HDF users, high convective volumes(>23L/session)were achieved in more than 60% of centers.Institutional protocols for high-flux HD or HDF were lacking in 33% of centers.Modality selection was primarily driven by expected patient outcomes(34%),followed by infrastructure(17.4%),cost(13.5%),and institutional policy(13.3%).In an ideal setting,clinicians preferred high-volume HDF(50.2%)over high-flux HD(27.1%).Respondents largely reported that online HDF improves outcomes (92.7%) and that high convective volumes are beneficial(88.5%).Broader implementation would be supported by 86.8% if barriers were removed.Awareness of the EuDial Consensus Statement was reported by 61% of respondents.

Conclusion

HDF is widely used in Europe and is supported by strong clinician confidence in its potential benefits, particularly for survival outcomes.However, broader adoption appears limited by structural and economic barriers.These findings highlight variability in practice and the need for strategies to support implementation of high-volume HDF.