Abstract: TH-PO0887
Effect of High-Volume Online Hemodiafiltration on Quality of Life, Perceived Stress, and Nutritional Parameters: A Mexican Single-Center Pilot Experience
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
- Estrada Mendez, Andrea, Centro Medico Nacional 20 de Noviembre, Mexico City, CDMX, Mexico
- Martinez Hernandez, Francisco Javier, Centro Medico Nacional 20 de Noviembre, Mexico City, CDMX, Mexico
- Lopez Mendoza, Monica, Centro Medico Nacional 20 de Noviembre, Mexico City, CDMX, Mexico
- García, Nicte Alaide Ramos, Centro Medico Nacional 20 de Noviembre, Mexico City, CDMX, Mexico
- Maldonado Tapia, Diana, Centro Medico Nacional 20 de Noviembre, Mexico City, CDMX, Mexico
- De los Santos Trejo, Julio Alfonso, Centro Medico Nacional 20 de Noviembre, Mexico City, CDMX, Mexico
Background
Despite limited access to online hemodiafiltration (OL-HDF) enhances middle-molecule clearance and hemodynamic tolerance, reducing mortality compared to conventional hemodialysis (CHD). However, most trials show no significant benefits regarding fatigue or quality of life. While OL-HDF solute clearance is well-documented, evidence simultaneously evaluating its impact on health-related quality of life and perceived stress in ESKD patients remains.
Methods
Quasi-experimental, longitudinal, pre-post study evaluated 11 ESKD patients transitioned from CHD to OL-HDF. At baseline and 6 months, we documented quality of life scores WHOQOL and PSS and clinical parameters. We used paired Student's t-tests, and bivariate associations, Software JASP (v0.18.3)
Results
Eleven ESKD patients (54.5% male; 50.1±13.2 years) completed the 6-month CHD to OL-HDF transition. Baseline spKtV-B2M was 1.47±0.23. After 6 months, PSS scores decreased from 36.45±3.75 to 21.45±4.74 (p=0.002, d=1.235, SE=0.490), while global WHOQOL-BREF scores improved from 61.91±4.56 to 73.36±6.93 (p<0.0001). Baseline spKtV-B2M was 1.47±0.23 and mean PSS scores dropped from 36.45±3.75 to 21.45±4.74.
Global quality of life improved (p<0.0001) and no changes occurred for spKtV-B2M 1.47 ± 0.23 vs. 1.30 ± 0.41, (p = 0.192) or B2M reduction ratio (p = 0.111; d = 0.527). Serum albumin remained stable (3.64±0.22 vs 3.84±0.26 g/dL; p=0.639, d=0.146), confirming OL-HDF does not induce a negative protein balance. At 6 months, absolute B2M levels showed no correlation with WHOQOL physical (r = 0.181, p = 0.594) or psychological (r = 0.098, p = 0.774).
Conclusion
Transitioning to OL-HDF significantly alleviates chronic distress and enhances quality of life in Mexican ESKD patients. The correlation between B2M and stress (r=0.419, p=0.200) reveals a clear clinical trend: a higher residual uremic burden tracks with elevated stress scores, directly linking solute clearance to psychological well-being.
Correlation between residual middle-molecule uremic burden and chronic stress perception