The Brazilian Society of Nephrology has issued recommendations on haemodiafiltration (HDF) in maintenance dialysis. HDF combines diffusive and convective clearance and removes middle-molecule uraemic toxins more effectively than conventional haemodialysis. The statement says that meta-analyses and the CONVINCE trial suggest high-volume HDF is associated with better clinical outcomes, particularly when adequate convective volumes are achieved.
The document is described by its authors as educational rather than normative. It is based on the best available evidence and expert consensus, and it covers patient selection, minimum prescription parameters, operational targets, technical and safety requirements, and ethical, regulatory and economic aspects. Its stated aim is to reduce practice variability and support clinical and managerial decisions in Brazil.
The abstract gives no specific targets or thresholds, so the detail is in the full document. The statement is a national society position, not a trial, and the abstract describes outcomes as suggested rather than established. The journal record carries a date of 2026 without a precise month, so it should not be read as newly released. For units in India, the main questions are access to HDF machines, ultrapure water and cost, which the statement does not address for this setting.
- High-volume HDF is associated with better outcomes than conventional haemodialysis when adequate convective volume is reached.
- If you offer HDF, audit the convective volume actually delivered, not only the prescribed modality.
- Read the full document for patient selection and prescription parameters; the abstract gives none.
- Check cost and water-quality requirements before expanding HDF.
Why it matters
The benefit of HDF seems to depend on how much convective volume is delivered, so a unit's practice matters as much as its equipment.
Don't overread it
This is an educational national statement with no new data, and the abstract reports no specific thresholds.
The statistics, in plain English
The statement cites trial and meta-analytic data on survival and cardiovascular outcomes but gives no numbers in its abstract. A position statement summarises evidence and opinion, so it cannot add new proof.
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