Effects Of Hemodiafiltration Versus Conventional Hemodialysis In Children With Eskd: The Hdf, Heart And Height Study

Abstract

Although studies suggest that hemodiafiltration (HDF) may reduce cardiovascular mortality in adults, data in children are sparse. In this observational multicenter study, the authors compared HDF and hemodialysis (HD) in children with ESKD, finding that annualized changes in well validated subclinical markers of cardiovascular disease, including carotid intima-media thickness SD scores, were lower in HDF and associated with lower 24-hour ambulatory BP and intradialytic weight gain. Height increased only in the HDF cohort. Compared with the HD cohort, the HDF cohort also had better self-reported outcomes, with fewer headaches, less dizziness or cramps, and shorter recovery time after dialysis sessions. The study provides proof-of-concept data that HDF is a safe treatment that may have benefits over conventional HD in children. A randomized trial is required to confirm these findings.,