ArticleMedical science monitor : international medical journal of experimental and clinical research2025
Comparative Analysis of Hemodiafiltration Methods: Efficacy and Safety in Maintenance Hemodialysis.
Article in Medical science monitor : international medical journal of experimental and clinical research, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Who cites it
1 citing paper in PubMed.
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Authors and funding
4 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
BACKGROUND The removal of uremic toxins in patients with end-stage renal disease is most effectively achieved through hemodiafiltration (HDF). Mixed-dilution HDF (mix-HDF) is a novel technique that automatically adjusts the infusion ratio between pre-dilution HDF (pre-HDF) and post-dilution HDF (post-HDF) based on transmembrane pressure feedback, maximizing filtration without compromising ultrafiltration. This prospective single-center study aimed to evaluate and compare the efficacy and safety of mix-HDF with pre-HDF and post-HDF in patients on stable chronic hemodialysis. MATERIAL AND METHODS Twenty-seven adult patients undergoing maintenance dialysis were treated sequentially with pre-HDF (T1), post-HDF (T2), and mix-HDF with varying dilution ratios: T3 (20: 10), T4 (15: 10), and T5 (15: 15). Key outcomes included urea reduction ratio, reduction ratios of ß2-microglobulin and alpha1-microglobulin, and total dialysate removal amounts. Secondary endpoints were blood flow, transmembrane pressure, convective volume, and convective volume completion rate. Statistical significance was determined using the Kruskal-Wallis and Wilcoxon tests (P<0.05). RESULTS Urea reduction ratio did not differ significantly among the groups (P>0.05). ß2-Microglobulin reduction ratio was significantly lower in pre-HDF vs post-HDF and mix-HDF (P<0.05), while a1-microglobulin reduction ratio remained lower overall. T5 (15: 15) mix-HDF achieved alpha1-microglobulin clearance closest to post-HDF. Transmembrane pressure was highest in T5, followed by T2. Convective volume completion rate was highest in pre-HDF and mix-HDF (20: 10). CONCLUSIONS Mix-HDF demonstrated similar performance to post-HDF for small and middle molecule clearance and offered improved control over transmembrane pressure. It presents a safe and effective alternative to conventional HDF modalities and warrants further clinical validation.
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