What is Online Hemodiafiltration?

By Dr. Dinesh Khullar in Nephrology , Kidney Transplant

Feb 28 , 2017 | 1 min read

Mr. A.K. had been suffering from poorly controlled diabetes for about twenty years and had been having progressively worsening kidney failure for the past five years. Three years back, he was started on hemodialysis in view of severe fluid overload in the body and advanced kidney failure.

Although he was undergoing conventional hemodialysis three times per week, he continued to have a poor appetite, intense intractable itching, high blood phosphorus levels and repeated episodes of hypotension during dialysis. In view of the above symptoms, he was shifted to online hemodiafiltration as the state of the art dialysis facility was now available at our Max Hospital, Saket.

How is it different from Conventional Dialysis?

In this procedure, the toxins are removed using principles of diffusion and convection. It offers a better survival to patients as compared to conventional dialysis- that involves only the principle of diffusion.

The most important requirement of hemodiafiltration is the availability of ultrapure (injection quality) water. It has been seen that many patients tolerate hemodiafiltration much better than hemodialysis with fewer hypertension episodes. Dr. Dinesh Khullar mentions a few benefits of this procedure:

  • Clearance of middle molecular toxins like beta 2 microglobulin, phosphorous, inflammatory cytokines, resulting in a lesser incidence of complications like dialysis-related amyloidosis.
  • Better control of renal bone disease
  • Its low pro-inflammatory cytokine levels lead to a decrease in cardiovascular mortality, improved nutrition, decrease itching, and better control of anaemia.

What were the results after the treatment?

Three months post the online hemodiafiltration, the patient reported much better quality of life. His appetite improved, less itching, phosphorus levels came down and he felt no more hypotension episodes during hemodialysis. Now, after 2.5 years, he continues to lead a normal life. This novel modality has been able to change the outcomes of several patients.