Maduell Francisco, Rodríguez-Espinosa Diana, Broseta José Jesús
Department of Nephrology, Hospital Clínic, 08036 Barcelona, Spain.
J Clin Med. 2024 Feb 16;13(4):1110. doi: 10.3390/jcm13041110.
This review provides a detailed analysis of hemodiafiltration (HDF), its progress from an emerging technique to a potential conventional treatment for chronic hemodialysis patients, and its current status. The article covers the advances, methods, and clinical benefits of HDF, specifically focusing on its impact on cardiovascular health, survival rates, and overall well-being. The review also addresses questions about the safety of HDF and provides evidence to dispel concerns related to the elimination of beneficial substances and infection risks. Additionally, the article explores the potential implications of expanded hemodialysis (HDx) as an alternative to HDF, its classification, safety profile, and an ongoing trial assessing its non-inferiority to HDF. Supported by evidence from randomized controlled trials and observational studies, the review emphasizes the superiority of HDF as a hemodialysis modality and advocates for its positioning as the gold standard in treatment. However, it acknowledges the need for extensive research to define the role of HDx in comprehensive treatment approaches in individuals undergoing dialysis. The synthesis of current knowledge underscores the importance of ongoing exploration and research to refine hemodialysis practices for optimal patient outcomes.
本综述对血液透析滤过(HDF)进行了详细分析,包括其从一种新兴技术发展成为慢性血液透析患者潜在常规治疗方法的历程及其当前状况。本文涵盖了HDF的进展、方法和临床益处,特别关注其对心血管健康、生存率和整体健康状况的影响。该综述还探讨了有关HDF安全性的问题,并提供证据以消除与有益物质清除和感染风险相关的担忧。此外,本文探讨了扩展血液透析(HDx)作为HDF替代方法的潜在意义、其分类、安全性概况以及一项评估其不劣于HDF的正在进行的试验。在随机对照试验和观察性研究证据的支持下,该综述强调了HDF作为一种血液透析方式的优越性,并主张将其定位为治疗的金标准。然而,它承认需要进行广泛研究以确定HDx在接受透析个体的综合治疗方法中的作用。当前知识的综合强调了持续探索和研究以优化血液透析实践以实现最佳患者结局的重要性。