Recommendations of the Brazilian Society of Nephrology for hemodiafiltration in maintenance dialysis therapy
Year: 2026
Type: article
Abstract: Hemodiafiltration (HDF) combines diffusive and convective clearance, enhancing the removal of uremic toxins, particularly middle molecules, compared with conventional hemodialysis (HD). Recent evidence, including meta-analyses and the CONVINCE trial, suggests that high-volume HDF is associated with improved clinical outcomes, particularly when adequate convective volumes are achieved. In Brazil, the expansion of this modality has been accompanied by studies demonstrating its feasibility, safety, and applicability across different clinical settings. This position statement from the Brazilian Society of Nephrology (SBN), educational rather than normative in nature, provides recommendations based on the best available evidence and expert consensus regarding the use of HDF in maintenance dialysis in Brazil. The document addresses patient selection, minimum prescription parameters, operational targets, technical and safety requirements, as well as ethical, regulatory, and economic aspects, with the aim of supporting clinical and managerial decision-making, reducing practice variability, and promoting safer, higher-quality dialysis care.
Source: Brazilian Journal of Nephrology
Authors: Fernanda Salomão Gorayeb-Polacchini, Rosilene Motta Elias, Ana Lydia Lédo de Castro Ribeiro Cabeça, Dirceu Reis da Silva, Elizabeth Machado, Farid Samaan, Isadora Cartaxo de Sousa Calvo, José Carolino Divino Filho, Kalyanne Cabral de Paula do Ó, Maria Gabriela Motta Guimarães, Maria Goretti Moreira Guimarães Penido, Patrícia Ferreira Abreu, Stenio Barbosa de Freitas, Vera Hermina Kalika Koch, José A. Moura-Neto
Institutions: Hospital de Base, Sociedade Brasileira de Nefrologia, Universidade de São Paulo, Universidade Nove de Julho, Hospital de Clínicas de Porto Alegre, Universidade do Vale do Rio dos Sinos, Secretaria da Saúde, Instituto Dante Pazzanese de Cardiologia, Karolinska Institutet, Universidade Federal da Bahia, International Renal Research Institute of Vicenza, Universidade Federal de Minas Gerais, Grupo Santa Casa de Belo Horizonte, Universidade Federal de São Paulo, Hospital São João de Deus, Escola Bahiana de Medicina e Saúde Pública
Language: English
Subfield: Nephrology
Field: Medicine
Domain: Health Sciences
Open Access status: diamond
OpenAlex ID: W7220384266