OUTCOME OF HEMODIALYSIS (HD) VERSUS HEMODIAFILTRATION (HDF) ON MORTALITY IN RENAL FAILURE

Main Article Content

Inamullah Khan
Zaryaab Ahmad Khan
Saiqa Sumbal
Khushal Khan
Shehzad Alam Khan
Aamer Ahmad
Faizan Banaras

Keywords

Abstract

Background: Chronic Kidney Disease (CKD) poses a significant health burden globally, with hemodialysis (HD) and hemodiafiltration (HDF) being common renal replacement therapies. The Nephrology Division at Khyber Teaching Hospital, Peshawar, has observed a rising trend in the prevalence of CKD cases. This study aims to compare the efficacy and outcomes of HD and HDF in a cohort of 200 patients over a six-month duration, from January 2023 to June 2023.


 


Aim: The primary objective of this study is to evaluate and compare the clinical effectiveness of Hemodialysis and Hemodiafiltration in terms of patient outcomes, biochemical parameters, and quality of life in Nephrology patients at Khyber Teaching Hospital.


 


Methods: A prospective cohort study was conducted, enrolling 200 CKD patients undergoing renal replacement therapy. The sample was divided equally into two groups: 100 patients receiving Hemodialysis and 100 patients undergoing Hemodiafiltration. Data were collected on demographic characteristics, pre-dialysis and post-dialysis biochemical markers, dialysis adequacy, and adverse events. Quality of life assessments was conducted using standardized tools. Statistical analyses, including t-tests and chi-square tests, have been employed to compare the outcomes between the two groups.


Results: Preliminary findings have been presented, comparing the efficacy of Hemodialysis and Hemodiafiltration in terms of clearance rates, fluid removal, and biochemical parameter control. Additionally, the study will explore the impact of each modality on the patients' quality of life. Statistical significance and clinical relevance of observed differences has been discussed.


 


Conclusion: The study aims to provide valuable insights into the comparative effectiveness of Hemodialysis and Hemodiafiltration, aiding healthcare professionals in making informed decisions regarding renal replacement therapies. The outcomes will contribute to the existing body of knowledge in nephrology and may guide future advancements in CKD management. The findings of this research are crucial for optimizing treatment strategies and improving patient outcomes in the Nephrology Division at Khyber Teaching Hospital Peshawar.

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References

1. Blankestijn, P. J., Vernooij, R. W., Hockham, C., Strippoli, G. F., Canaud, B., Hegbrant, J., ... & Bots, M. L. (2023). Effect of hemodiafiltration or hemodialysis on mortality in kidney failure. New England Journal of Medicine.
2. Sarhaan, I. I., Hassan, M. S., Mahmoud, A. M., & Gharib, M. S. (2023). Is online hemodiafiltration superior to hemodialysis in removal of indoxyl sulfate in chronic hemodialysis patients? A comparative study. Journal of The Egyptian Society of Nephrology and Transplantation, 23(4), 149-155.
3. Mitchell, C. R., Hornig, C., & Canaud, B. (2023, March). Systematic review to compare the outcomes associated with the modalities of expanded hemodialysis (HDx) versus high‐flux hemodialysis and/or hemodiafiltration (HDF) in patients with end‐stage kidney disease (ESKD). In Seminars in Dialysis (Vol. 36, No. 2, pp. 86-106).
4. Ma, S., Pu, N., & Ma, J. (2023). Effects of high-flux hemodialysis and hemodiafiltration on the mortality of patients with end-stage kidney disease: a meta-analysis. Renal Failure, 45(1), 2147436.
5. Silva, L. C. D. A., Correia, M. D. A., Gouveia, R. D., Souza, M. S., Junior, C. I. P., Parrillo, F., ... & Elias, R. M. (2023). Effects of nutritional supplementation stabilizing muscle mass loss in older patients on hemodiafiltration. Clinical Nutrition ESPEN, 58, 97-103.
6. Khamis, S. S. A., Zahran, A. M., Elsharkawy, M. M. S., Soliman, A. E. A., & Torayah, M. M. (2023). Assessment of postdialysis recovery time and associated hemodynamic changes by cardiometry in hemodiafiltration compared to conventional hemodialysis in patients on regular renal replacement therapy. Journal of The Egyptian Society of Nephrology and Transplantation, 23(4), 156-170.
7. Pedreros-Rosales, C., Jara, A., Lorca, E., Mezzano, S., Pecoits-Filho, R., & Herrera, P. (2023). Unveiling the Clinical Benefits of High-Volume Hemodiafiltration: Optimizing the Removal of Medium-Weight Uremic Toxins and Beyond. Toxins, 15(9), 531.
8. de Sequera, P., Pérez-García, R., Vega, A., Martínez-Vaquera, S., Acosta, J. G., Pérez Del Valle, K., ... & Maduell, F. (2023). Trial design of the MOTheR HDx study: a multicenter, open-label, prospective, randomized study to explore the morbidity and mortality in patients dialyzed with the Theranova HDx in comparison with online hemodiafiltration. Clinical Kidney Journal, 16(11), 2254-2261.
9. Ma, X. Y., Sheng, Y. P., Yang, X. M., Zhang, H. R., & Sun, F. Y. (2023). Effects of paricalcitol combined with hemodiafiltration on bone-metabolism-related indexes in patients with diabetic nephropathy and chronic renal failure. World Journal of Diabetes, 14(9), 1385.
10. Mangione, E., Giannese, D., Cupisti, A., & Panichi, V. (2023). ABCs of hemodiafiltration prescription: The Pisa style. Journal of Nephrology, 1-5.
11. de Moura, P. F. J. D., da Silva Nunes, B. S. D., Ribeiro, M. J. S., do Nascimento, M. J. G., Macedo, B. S. A., Souza, M. E. S. P., ... & Kuckelhaus, P. D. S. A. S. (2023). Conversion from hemodialysis to hemodiafiltration affects innate immunity of individuals with chronic kidney disease.
12. Goto, S., Fujii, H., Mieno, M., Yagisawa, T., Abe, M., Nitta, K., & Nishi, S. (2023). Survival benefit of living donor kidney transplantation in patients on hemodialysis. Clinical and Experimental Nephrology, 1-10.
13. Lang, T., Zawada, A. M., Theis, L., Braun, J., Ottillinger, B., Kopperschmidt, P., ... & Canaud, B. (2023). Hemodiafiltration: Technical and Medical Insights. Bioengineering, 10(2), 145.
14. Lang, T., Zawada, A. M., Theis, L., Braun, J., Ottillinger, B., Kopperschmidt, P., ... & Canaud, B. (2023). Hemodiafiltration: Technical and Medical Insights. Bioengineering, 10(2), 145.
15. Vernooij, R. W., Hockham, C., Barth, C., Canaud, B., Cromm, K., Davenport, A., ... & Blankestijn, P. J. (2023). High-Target Hemodiafiltration Convective Dose Achieved in Most Patients in a 6-Month Intermediary Analysis of the CONVINCE Randomized Controlled Trial. Kidney International Reports.
16. Sakuma, H., Matsuki, M., Hasebe, N., & Nakagawa, N. (2023). Real‐world trends in pre‐dialysis blood pressure levels of patients undergoing dialysis in Japan using a web‐based national database. The Journal of Clinical Hypertension.
17. Lambert, H., Hiu, S., Coulthard, M. G., Matthews, J. N., Holstein, E. M., Crosier, J., ... & Wood, R. (2023). The Infant KIdney Dialysis and Utrafiltration (I-KID) Study: A Stepped-Wedge Cluster-Randomized Study in Infants, Comparing Peritoneal Dialysis, Continuous Venovenous Hemofiltration, and Newcastle Infant Dialysis Ultrafiltration System, a Novel Infant Hemodialysis Device. Pediatric Critical Care Medicine, 10-1097.
18. Drüeke, T. B., & Ikizler, T. A. (2023). Is hemodiafiltration superior to hemodialysis in patients with kidney failure?. Kidney International, 104(5), 874-877.
19. Nguyen, N. N., Le, V. Q., Huynh, A. T., Van Le, M., & Mai, T. H. N. (2023). Correlation between nerve conduction changes and BETA-2 microglobulin concentration in chronic kidney disease patients on hemodialysis combined with hemodiafiltration online. Medicine, 102(7).
20. Aszkiełowicz, A., Steckiewicz, K. P., Okrągły, M., Wujtewicz, M. A., & Owczuk, R. (2023). The Impact of Continuous Veno-Venous Hemodiafiltration on the Efficacy of Administration of Prophylactic Doses of Enoxaparin: A Prospective Observational Study. Pharmaceuticals, 16(8), 1166.
21. Reis, T., Hutchison, C., de Assis Rocha Neves, F., Zawadzki, B., Zanella, M., Ronco, C., & Rosner, M. H. (2023). Rationale for a New Classification of Solutes of Interest in Chronic Kidney Disease and Hemodialysis. Blood Purification, 52(3), 242-254.
22. Buzancais, A., Brunot, V., Larcher, R., Tudesq, J. J., Platon, L., Besnard, N., ... & Klouche, K. (2023). Sodium flux during hemodialysis and hemodiafiltration treatment of acute kidney injury: Effects of dialysate and infusate sodium concentration at 140 and 145 mmol/L. Artificial Organs, 47(6), 999-1006.
23. Daugirdas, J., & Chan, C. T. (2023). Survival Benefit with Hemodiafiltration: Are We Convinced and if So, What Might Be the Mechanism?. Clinical Journal of the American Society of Nephrology, 10-2215.
24. Chander, S., Lohana, S., Sadarat, F., & Kumari, R. (2023). Mortality and Mode of Dialysis. Meta-Analysis and Systematic Review. medRxiv, 2023-02.
25. Shikha, D., & Mishra, S. A comparative study of nutritional assessment and dietary modification impact on end stage renal disease (esrd) patients on haemodialysis.