ReviewToxins2026
Hemodiafiltration in Dialysis Practice: Global Adoption, Toxin Clearance, Inflammation Control, and Clinical Safety.
Review in Toxins, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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.
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.
Who cites it
0 citing papers in PubMed.
No citing paper in PubMed yet.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
6 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Hemodiafiltration (HDF) combines diffusion and convection to enhance solute removal compared with hemodialysis (HD). While widely adopted in Europe and parts of Asia, uptake elsewhere remains limited due to regulatory, reimbursement, and infrastructural constraints. Recent randomized trials, large observational studies, and meta-analyses have renewed interest in HDF, particularly post-dilution HDF achieving convection volumes of ≥23 L/session, in which the most consistent clinical benefits have been observed. This review summarizes the mechanistic rationale, clinical effects, and safety profile of high-volume HDF. Compared with HD, HDF provides consistently superior removal of middle molecules, whereas clearance of protein-bound uremic toxins (PBUTs) remains constrained by albumin binding and compartmental redistribution, resulting in only modest or variable advantages. Emerging strategies aimed at releasing or capturing PBUTs may address this gap. Beyond solute removal, evidence suggests that HDF may lower micro-inflammation by enhanced clearance of inflammatory mediators and reduced immune activation. When delivered with adequate infrastructure, monitoring, modern equipment, ultrapure fluids, trained staff, appropriate vascular access, and anticoagulation, high-volume HDF has a favorable safety profile and is associated with fewer intradialytic hypotension (IDH) events and improved treatment tolerability. Available evidence has not identified a consistent excess risk of device- or infection-related complications, although comparative data remain limited. Overall, current evidence supports clinically relevant advantages of high-volume HDF under optimal treatment conditions. However, important challenges remain, particularly the limited removal of PBUTs, underscoring the need for further innovation in uremic toxin management.
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Registered trials
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.