Abstract: TH-PO0867
Dialysate Conservation Among Patients on Hemodialysis Transitioning to Hemodiafiltration with AutoSub Plus
Session Information
- Dialysis: Prescription, Physiology, and Treatment Optimization
October 22, 2026 | Location: Exhibit Hall A, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Dialysis
- 801 Dialysis: Hemodialysis and Frequent Dialysis
Authors
- Zhou, Meijiao, Renal Research Institute, Waltham, Massachusetts, United States
- Chen, Ming, Renal Research Institute, Waltham, Massachusetts, United States
- Van Zandt, Carly R., Renal Research Institute, Waltham, Massachusetts, United States
- Ficociello, Linda, Renal Research Institute, Waltham, Massachusetts, United States
- Anger, Michael S., Fresenius Medical Care, Waltham, Massachusetts, United States
- Stuard, Stefano, Fresenius Medical Care, Pignano, Italy
- Chatoth, Dinesh K., Fresenius Medical Care, Waltham, Massachusetts, United States
Background
Hemodiafiltration (HDF), a renal replacement therapy combining convection and diffusion, may allow lower dialysate flow rates that lead to dialysate savings despite the addition of substitution volume. A prior single-clinic study using treatment-level data suggested that HDF with AutoSub plus (HDF AS+) reduced dialysate use. This current study evaluated changes in dialysate consumption after transition from conventional HD to HDF AS+ in a larger cohort with longer follow up.
Methods
Adult in-center Fresenius Kidney Care (FKC) HD patients who transitioned from conventional HD to HDF AS+ as part of routine care for 1- 3 months were included. Eligible patients completed at least 12 HD and 12 HVHDF treatments on 5008X CAREsystem. The index date was defined as the first HDF AS+ treatment. A one-month transition period before the index date was excluded. The HD period was defined as 31-120 days before the index date, and the HDF AS+ period as 0-89 days after the index date. Parameters were averaged within each treatment period.
Results
A total of 128 patients were included. Mean age was 61 years, mean dialysis vintage was 46 months, 32% were female, 18% were Hispanic, and 32% were African American.
Following transition to HDF AS+, prescribed and delivered blood flow rates, treatment time, and ultrafiltration volume remained stable. Online Clearance (OLC) Kt/V showed increases from 1.62 to 1.77. Prescribed dialysate flow rate (Qd) decreased from 657 to 462 mL/min and delivered Qd decreased from 635 to 470 mL/min. Using treatment time, delivered Qd, and substitution volume, estimated dialysate use decreased by 12 L per treatment.
Conclusion
Compared with conventional HD, HDF AS+ was associated with lower dialysate flow rates, reduced dialysate use, and higher dialysis adequacy.
Funding
- Commercial Support – Fresenius Medical Care