HDF works by combining diffusion with convection and is known to clear middle molecules better than HD alone. Unfortunately however, some of the proposed benefits of HDF have not played out as expected. HDF has been shown to have no mortality or CVD benefit over HD. Still, there were hints from various studies that there may be a benefit in terms of health-related quality of life (HRQOL) for patients on HDF. For patients on dialysis, this would be a big deal. This month’s article highlighted in eJournal club attempted to answer this question.
This was a randomized trial using data from the CONTRAST study comparing HD with HDF. HRQOL was a prespecified secondary outcome. Over an average of two years follow-up all domains of HRQOL declined except for overall health which improved in the HDF patients although there was no significant difference from the HD patients. These results were disappointing.
Head over the eJournal Club to continue the discussion.