Online hemodiafiltration – A systematic review

The survival of patients on hemodialysis is very poor when compared to kidney transplantation. Several attempts have been made to improve the survival of dialysis patients. Some such attempts are more frequent dialysis, more prolonged dialysis, use of high flux dialyzers, use of ‘ultrapure’ dialysate, and better electrolyte and mineral metabolism. Hemodiafiltration is one such measure, where both diffusive and convective methods of toxin removal are exploited with a view of removing both small molecular weight and larger molecular weight toxins from the body. Over last 2 decades several studies with confronting results regarding hemodiafiltration and survival outcome are published and hence need for a review.