Haemodiafiltration, haemofiltration and haemodialysis for adults with kidney failure

Convective extracorporeal dialysis modalities, haemofiltration (HF), haemodiafiltration (HDF), and acetate-free biofiltration (AFB), remove excess body fluid across the dialysis membrane through an interplay of positive and negative pressures and accumulated middle- and larger-sized solutes more efficiently than haemodialysis (HD). This increased removal of larger solutes, combined with the use of ultrapure dialysis fluid in convective dialysis, is hypothesised to reduce the frequency and severity of symptoms during HD and improve long-term clinical outcomes. This is an update of a review first published in 2006 and updated in 2015.

To determine the benefits and harms of convective (HF, HDF, or AFB) versus diffusive (HD) dialysis modalities, or expanded HD (HDx), in preventing all-cause and cardiovascular death, cardiovascular morbidity, fatigue, and vascular access problems in adults with kidney failure.