Unveiling the Clinical Benefits of High-Volume Hemodiafiltration: Optimizing the Removal of Medium-Weight Uremic Toxins and Beyond

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dc.article.number15090531
dc.catalogadoraba
dc.contributor.authorPedreros, Cristian
dc.contributor.authorJara Contreras, Aquiles
dc.contributor.authorLorca, Eduardo
dc.contributor.authorMezzano, Sergio
dc.contributor.authorPecoits-Filho, Roberto
dc.contributor.authorHerrera, Patricia
dc.date.accessioned2023-09-11T15:11:54Z
dc.date.available2023-09-11T15:11:54Z
dc.date.issued2023
dc.description.abstractDialysis treatment has improved the survival of patients with kidney failure. However, the hospitalization and mortality rates remain alarmingly high, primarily due to incomplete uremic toxin elimination. High-volume hemodiafiltration (HDF) has emerged as a promising approach that significantly improves patient outcomes by effectively eliminating medium and large uremic toxins, which explains its increasing adoption, particularly in Europe and Japan. Interest in this therapy has grown following the findings of the recently published CONVINCE study, as well as the need to understand the mechanisms behind the benefits. This comprehensive review aims to enhance the scientific understanding by explaining the underlying physiological mechanisms that contribute to the positive effects of HDF in terms of short-term benefits, like hemodynamic tolerance and cardiovascular disease. Additionally, it explores the rationale behind the medium-term clinical benefits, including phosphorus removal, the modulation of inflammation and oxidative stress, anemia management, immune response modulation, nutritional effects, the mitigation of bone disorders, neuropathy relief, and amyloidosis reduction. This review also analyzes the impact of HDF on patient-reported outcomes and mortality. Considering the importance of applying personalized uremic toxin removal strategies tailored to the unique needs of each patient, high-volume HDF appears to be the most effective treatment to date for patients with renal failure. This justifies the need to prioritize its application in clinical practice, initially focusing on the groups with the greatest potential benefits and subsequently extending its use to a larger number of patients.
dc.fechaingreso.objetodigital2023-09-01
dc.fuente.origenORCID
dc.identifier.doi10.3390/toxins15090531
dc.identifier.eissn2072-6651
dc.identifier.urihttps://doi.org/10.3390/toxins15090531
dc.identifier.urihttps://repositorio.uc.cl/handle/11534/74585
dc.information.autorucEscuela de Medicina; Pedreros Rosales, Cristian Eduardo; 0000-0002-1338-0503; 227698
dc.information.autorucEscuela de Medicina; Jara Contreras, Aquiles; S/I; 99877
dc.issue.numero9
dc.language.isoen
dc.nota.accesoContenido completo
dc.pagina.final22
dc.pagina.inicio1
dc.revistaToxins
dc.rightsacceso abierto
dc.subjectHemodiafiltration
dc.subjectKidney failure
dc.subjectDialysis
dc.subjectUremic toxins
dc.subjectHemodynamic tolerance
dc.subjectCardiovascular disease
dc.subjectInflammation
dc.subjectOxidative stress
dc.subjectPatient-reported outcomes
dc.subjectMortality
dc.subject.ddc610
dc.subject.deweyMedicina y saludes_ES
dc.titleUnveiling the Clinical Benefits of High-Volume Hemodiafiltration: Optimizing the Removal of Medium-Weight Uremic Toxins and Beyond
dc.typeartículo
dc.volumen15
sipa.codpersvinculados227698
sipa.codpersvinculados99877
sipa.trazabilidadORCID;2023-09-04
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