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Peer-reviewedCC BYJornal brasileiro de nefrologia

Recommendations of the Brazilian Society of Nephrology for hemodiafiltration in maintenance dialysis therapy.

  • Fernanda Salomão Gorayeb-Polacchini1,2
  • Rosilene Motta Elias1,3,4
  • Ana Lydia Lédo de Castro Ribeiro Cabeça1,5
  • Dirceu Reis da Silva1,6,7,8
  • Elizabeth Machado1
  • Farid Samaan1,9,10
  • Isadora Cartaxo de Sousa Calvo1
  • José Carolino Divino Filho11,12
  • Kalyanne Cabral de Paula do Ó1
  • Maria Gabriela Motta Guimarães1,13,14
  • Maria Goretti Moreira Guimarães Penido1,15,16
  • Patrícia Ferreira Abreu1,17
3 more authors
  • Stenio Barbosa de Freitas1,18
  • Vera Hermina Kalika Koch1,19
  • José A Moura-Neto1,20
20 affiliations
  1. 1Brazilian Society of Nephrology, São Paulo, SP, Brazil.
  2. 2Hospital de Base-FUNFARME, São José do Rio Preto, SP, Brazil.
  3. 3Universidade de São Paulo, São Paulo, SP, Brazil.
  4. 4Universidade Nove de Julho, São Paulo, SP, Brazil.
  5. 5Fundação Hospital de Clínicas Gaspar Vianna, Belém, PA, Brazil.
  6. 6Hospital de Clínicas de Porto Alegre, Porto Alegre, RS, Brazil.
  7. 7Instituto de Doenças Renais, Porto Alegre, RS, Brazil.
  8. 8Universidade do Vale do Rio dos Sinos, São Leopoldo, RS, Brazil.
  9. 9Secretaria de Saúde do Estado de São Paulo, São Paulo, SP, Brazil.
  10. 10Instituto Dante Pazzanese de Cardiologia, São Paulo, SP, Brazil.
  11. 11Karolinska Institutet, Department of Clinical Science, Intervention and Technology, Division of Renal Medicine, Stockholm, Sweden.
  12. 12VIVATUM PD AG, Eschenbach, Switzerland.
  13. 13Vicenza International Institute of Kidney Research, Vicenza, Italia.
  14. 14Universidade Federal da Bahia, Programa de Pós-Graduação em Ciências da Saúde, Salvador, BA, Brazil.
  15. 15Santa Casa de Belo Horizonte, Unidade de Nefrologia Pediátrica, Belo Horizonte, MG, Brazil.
  16. 16Universidade Federal de Minas Gerais, Faculdade de Medicina, Belo Horizonte, MG, Brazil.
  17. 17Universidade Federal de São Paulo, São Paulo, SP, Brazil.
  18. 18Hospital São João de Deus, Divinópolis, MG, Brazil.
  19. 19Universidade de São Paulo, Faculdade de Medicina, Hospital das Clínicas, Instituto da Criança, São Paulo, SP, Brazil.
  20. 20Faculdade Bahiana de Medicina e Saúde Pública, Salvador, BA, Brazil.
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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.

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Cite

BibTeXRIS
BibTeX
@article{gorayebpolacchini2026recommendations,
  title = {{Recommendations of the Brazilian Society of Nephrology for hemodiafiltration in maintenance dialysis therapy.}},
  author = {Fernanda Salomão Gorayeb-Polacchini and Rosilene Motta Elias and Ana Lydia Lédo de Castro Ribeiro Cabeça and Dirceu Reis da Silva and Elizabeth Machado and Farid Samaan and Isadora Cartaxo de Sousa Calvo and José Carolino Divino Filho and Kalyanne Cabral de Paula do Ó and Maria Gabriela Motta Guimarães and Maria Goretti Moreira Guimarães Penido and Patrícia Ferreira Abreu and Stenio Barbosa de Freitas and Vera Hermina Kalika Koch and José A Moura-Neto},
  journal = {Jornal brasileiro de nefrologia},
  year = {2026},
  month = oct,
  doi = {10.1590/2175-8239-jbn-2026-0161en},
  url = {https://europepmc.org/article/MED/42837114},
  note = {CC BY},
}
RIS
TY  - JOUR
TI  - Recommendations of the Brazilian Society of Nephrology for hemodiafiltration in maintenance dialysis therapy.
AU  - Fernanda Salomão Gorayeb-Polacchini
AU  - Rosilene Motta Elias
AU  - Ana Lydia Lédo de Castro Ribeiro Cabeça
AU  - Dirceu Reis da Silva
AU  - Elizabeth Machado
AU  - Farid Samaan
AU  - Isadora Cartaxo de Sousa Calvo
AU  - José Carolino Divino Filho
AU  - Kalyanne Cabral de Paula do Ó
AU  - Maria Gabriela Motta Guimarães
AU  - Maria Goretti Moreira Guimarães Penido
AU  - Patrícia Ferreira Abreu
AU  - Stenio Barbosa de Freitas
AU  - Vera Hermina Kalika Koch
AU  - José A Moura-Neto
PY  - 2026
DA  - 2026/10/01
JO  - Jornal brasileiro de nefrologia
DO  - 10.1590/2175-8239-jbn-2026-0161en
UR  - https://europepmc.org/article/MED/42837114
AB  - 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.
SN  - 0101-2800
SN  - 2175-8239
ER  -