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Effect of online hemodiafiltration on morbidity and mortality of chronic kidney disease patients.

Conventional diffusion-based dialysis modalities including high-flux hemodialysis (HD) are limited in their capacity to clear uremic toxins. Moreover they are associated with a relatively high incidence of morbidity and mortality. Online hemodiafiltration (ol-HDF) combining the use of a high-flux membrane dialyzer, ultrapure dialysis fluid and high convective fluid exchange is highly efficient with the lowest bioreactive profile in renal replacement therapy methods. Regular use of high-efficiency ol-HDF is associated with reduced morbidity (hypotension incidence, better blood pressure control, improved hemocompatibility, reduced inflammation profile, improved lipid profile, improved anemia correction, reduced incidence of beta2-microglobulin amyloidosis and hospitalization). More recently, several cohort studies have shown that high-efficiency ol-HDF is associated with a 35% reduced risk of mortality in an unselected dialysis population. ol-HDF has been proven to be a safe and very efficient renal replacement therapy. ol-HDF has come of age and should be considered now as the new standard for highly efficient renal replacement therapy.