Comparison of survival between dialysis patients with incident high-flux hemodialysis versus on-line hemodiafiltration : a single center experience in Saudi Arabia

• Published in: Saudi journal of kidney diseases and transplantation Vol. 29; no. 1; pp. 107 - 113
• Main Authors: al-Furayyih, Uthman I., Rashwan, Muhammad, Abd al-Salam, Muhammad Said, al-Thaf, Muhammad Mahdi, Ibrahim, Ihab A., al-kurbi, Lutfi A.
• Format: Journal Article
• Language: English
• Published: Riyadh, Saudi Arabia Saudi Center for Organ Transplantation 2018; Wolters Kluwer India Pvt. Ltd; Medknow Publications and Media Pvt. Ltd; Medknow Publications & Media Pvt. Ltd; Wolters Kluwer Medknow Publications
• Subjects: Age; Analysis; Care and treatment; Chronic kidney failure; Clinical outcomes; Comorbidity; Comparative analysis; Diabetes; Health aspects; Hemodialysis; Hemodialysis patients; Hemofiltration; Hospitals; Hypertension; Internal medicine; Medicine; Mortality; Nephrology; Patient outcomes; Patients; Research centers; Transplants & implants; Treatment outcome; الترشيح; الدم; المرضى; علم المداواة; غسيل الكلى; Saudi Arabia; Cairo Egypt; United States > US; Riyadh Saudi Arabia
• ISSN: 1319-2442; 2320-3838
• DOI: 10.4103/1319-2442.225191

Conventional hemodialysis (HD) is the most common treatment modality used for renal replacement therapy. The concept of HD is based on the diffusion of solutes across a semipermeable membrane. Hemofiltration (HF) is based on convective transport of solutes; hemodiafiltration (HDF) is based on combined convective and diffusive therapies. Data about survival benefit of on-line HDF (OL-HDF) over high-flux HD (HF-HD) is conflicting. We conducted this study to investigate if there is a survival difference between the two treatment modalities. This study is a retrospective, single-center study in which 78 patients were screened; 18 were excluded and 60 patients were analyzed. The study patients were aged 47.5 ± 20.7 years, 33 patients (55%) were on HF-HD, and 27 patients (45%) were on OL-HDF. A total of 24 patients (40%) of both groups were diabetic and, the mean duration on dialysis was 43.5 ± 21.3 months in the HF-HD group and 41.2 ± 22.0 months in the OL-HDF group. The mean substitution volume for OL-HDF was 22.3 ± 2.5 L. Survival was 73% [95%, confidence interval (CI) 60–84] in the HF-HD group and 65% (95%, CI 54–75) in the OL-HDF group by the end of the study period. The unadjusted hazard ratio (HR) with 95% CI comparing HF-HD to high-volume postdilution OL-HDF