Hemodiafiltration Improves Survival Among Nondiabetics, Individuals Without Cardiovascular Disease, and the Elderly: A Systematic Review and Meta-Analysis.

INTRODUCTION

Hemodialysis (HD) is the most widely utilized dialysis method globally. However, hemodiafiltration (HDF) is garnering significant interest. This study aimed to evaluate mortality rates in patients with end-stage kidney disease (ESKD) using HDF in comparison to high-flux HD (hf-HD).

METHODS

The Cochrane, Embase, Epistemonikos, and PubMed databases were searched until October 30, 2024.

RESULTS

Seven studies met the inclusion criteria. Compared to the hf-HD group, the risk ratio (RR) for all-cause mortality with HDF was 0.78 (95% CI 0.68-0.89). Likewise, the risks of cardiovascular death and infection-related death were lower in the HDF group. Subgroup analysis indicated a reduction in all-cause mortality among nondiabetic patients in the HDF group. ESKD patients without preexisting cardiovascular disease (CVD) exhibited an RR of 0.61 (95% CI 0.45-0.77) for all-cause deaths.

CONCLUSIONS

The use of HDF in comparison to hf-HD reduced the risk of death in nondiabetic patients and those without preexisting CVD. Given the high cost associated with HDF, further studies are necessary to confirm these findings.