5-Year Mortality Outcomes of High-Volume Hemodiafiltration in Mexico: Insights from Real-World Data

Background: High volume hemodiafiltration (HDF) offers significant benefits for patients undergoing renal replacement therapy. The objective of this study is to evaluate real world data and assess mortality between pre and post dilutional HDF modalities. Methods: In this observational, cross-sectional, retrospective study we analyzed all prescribed sessions over a 5-year period in our HDF clinic to evaluate overall mortality rates and assess mortality differences between pre- and post-dilutional HDF modalities. The statistical analysis was made using mortality rates and Mantel-Cox test. Results: 89 patients of whom 66.3% were female were included with a total of 26,047 HDF sessions over the past five years. During the study period, outcomes included 16 deaths, 23 kidney transplants, 5 peritoneal dialysis transition, 1 loss to follow-up, and 2 cases of kidney function recovery. . The distribution of vascular access types revealed 59 tunneled catheters, 10 non-tunneled catheters, and 20 arteriovenous fistulas. Patients were further categorized based on HDF modality (table 1.) Mortality rates demonstrated no significant differences between the two HDF modalities, yielding an overall mortality rate of 0.8 per 1,000 population—0.7 for pre-dilution HDF and 0.8 for post-dilution HDF (logrank: 0.9785). Conclusion: No mortality differences were found between pre and post dilutional OL- HDF. Larger studies are warranted to confirm our findings. - HDF postdilutional n=60 HDF predilutional n=29 p-value Age (y) 39.5 (31-54.5) 35 (28-46) 0.11 Length of session (min) 187 (184-194) 187 (183-197) 0.84 EtiologyDiabetic Kidney Disease n(%) 10 (16.6) 1 (3.4) 0.20 Unknown etiology n (%) 21 (35) 11 (37.9) 0.20 Other n (%) 29 (48.3) 17 (58.6) 0.20 Convective volume (L) 24.8 (23.7-26) 39.9 (33-46.3) ≤0.001 Ultrafiltration rate (ml/kg/hr) 11.5 ± 3.3 11.1 ± 3.5 0.65 Blood flow (ml/min) 389 (373-404) 394 (382-404) 0.59