Evidence map›Paper›PMID 42232593›Full record

ReviewClinical kidney journal2026

Hemodiafiltration beyond the CONVINCE trial.

Giovanni F M Strippoli, Krister Cromm, Vasileios C Pezoulas, Nikolaos Tachos, Dimitrios I Fotiadis, Allison Jaure, Jolanta Malyszko, Michael Anger, Felix Fischer, Jörgen Hegbrant and 2 more

Abstract readReview
PubMed Full text at PMC Publisher
In one paragraph

Review in Clinical kidney journal, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

12 authors.

Giovanni F M StrippoliSydney School of Public Health, The University of Sydney, NSW, Australia.ORCID https://orcid.org/0000-0002-6936-0616
Krister CrommCenter for Patient-Centered Outcomes Research, Department of Psychosomatic Medicine, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany.
Vasileios C PezoulasUnit of Medical Technology and Intelligent Information Systems, Department of Materials Science and Engineering, University of Ioannina, Ioannina, Greece.
Nikolaos TachosUnit of Medical Technology and Intelligent Information Systems, Department of Materials Science and Engineering, University of Ioannina, Ioannina, Greece.
Dimitrios I FotiadisUnit of Medical Technology and Intelligent Information Systems, Department of Materials Science and Engineering, University of Ioannina, Ioannina, Greece.
Allison JaureSydney School of Public Health, The University of Sydney, NSW, Australia.
Jolanta MalyszkoDepartment of Nephrology, Dialysis and Internal Medicine, Medical University of Warsaw, Warsaw, Poland.
Michael AngerUniversity of Colorado Anschutz School of Medicine, Aurora, CO, USA.
Felix FischerCenter for Patient-Centered Outcomes Research, Department of Psychosomatic Medicine, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany.
Jörgen HegbrantDivision of Nephrology, Department of Clinical Sciences, Lund University, Lund, Sweden.
Sagar NigwekarDivision of Nephrology, Department of Medicine, Massachusetts General Brigham, Boston, MA, USA.
Rümeyza KazancıoğluDivision of Nephrology, School of Medicine, Bezmialem Vakif University, Istanbul, Türkiye.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Online hemodiafiltration (HDF) is a dialysis modality that can improve patient outcomes beyond those achieved with conventional high-flux hemodialysis (HD) in patients with kidney failure. The CONVINCE trial, the latest and the largest of a series of randomized trials comparing HDF with HD, demonstrated a 23% reduction in the risk of all-cause mortality with high-volume HDF compared to high-flux HD. Systematic reviews of the totality of evidence confirmed cardiovascular and survival benefits of HDF. Further hard-endpoint trials are unlikely to change these findings. The challenge is implementation of these findings in clinical care. Nephrology is used to timeframes of 10-15 years before innovation gets implemented at the bedside, and this may well apply to HDF, particularly in regions where structural, regulatory, and financial barriers persist. In this narrative review, we discuss in broad terms the key items of a forward-looking research agenda for HDF after CONVINCE. Key priorities include real-world implementation studies; a strong focus on patient-reported outcomes; mechanistic research to understand why HDF is superior to HD and exploring personalized HDF regimens. Attaining these priorities will require leveraging innovative methods and we discuss two, target trial emulation methods and use of digital twin technologies. We aim to stimulate reflection and enthusiasm toward a modern approach to dialysis research that embraces innovation and centers on patient priorities. We advocate for world-class clinical guidelines on HDF, avoidance of opinion and position statements and a decisive, creative, and innovative research path. Patients with kidney failure deserve care informed by the best available evidence, implemented through rigorous guideline processes and adapted to patient preferences, health-system context, and feasibility.

Indexed as

convectiondigital-twinguidelinehemodiafiltrationreview

Identifiers

PMID42232593
PMCPMC13224832

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.