Hemodiafiltration(HDF)

Posted on Jan 15, 2018
By Dr. Rajesh Kumar

Standard Dialysis utilizes diffusive clearance therapy as a means of purifying blood. Hemodiafiltration (HDF) is a form of renal replacement therapy that uses convective as well as diffusive clearance.

Studies show that standard dialysis has some issues in clearance of middle level molecules. In contrast, hemodiafiltration (HDF) increases the clearance of larger toxins by large-volume ultrafiltration. Ultrafiltration carries toxins through the membrane pores by fluid flow, also known as convection. As long as the toxin molecule can easily pass through the membrane pores, the rate of transfer is independent of the molecule size.

HDF is available in the United States but not commonly used. In Europe, Japan, and some other  countries where HDF is commonly used, most clinicians use a specific type of HDF termed online HDF. In online HDF, the substitution fluid is produced by the dialysis machine, which enables large convection volumes.

Recent research has validated that not only does HDF result in better quality of life but has also resulted in increased long term patient survival, preservation of heart function. Patients have also noted that they have better phosphorous and blood pressure control. Due to efficient toxin clearance patients have more choice in diet.