This review provides a detailed analysis of hemodiafiltration (HDF), its progress from an emerging technique to a potential conventional treatment for chronic hemodialysis patients, and its current status. The article covers the advances, methods, and clinical benefits of HDF, specifically focusing on its impact on cardiovascular health, survival rates, and overall well-being. The review also addresses questions about the safety of HDF and provides evidence to dispel concerns related to the elimination of beneficial substances and infection risks. Additionally, the article explores the potential implications of expanded hemodialysis (HDx) as an alternative to HDF, its classification, safety profile, and an ongoing trial assessing its non-inferiority to HDF. Supported by evidence from randomized controlled trials and observational studies, the review emphasizes the superiority of HDF as a hemodialysis modality and advocates for its positioning as the gold standard in treatment. However, it acknowledges the need for extensive research to define the role of HDx in comprehensive treatment approaches in individuals undergoing dialysis. The synthesis of current knowledge underscores the importance of ongoing exploration and research to refine hemodialysis practices for optimal patient outcomes.
Keywords: dialyzer compatibility; hemodiafiltration; safety; survival.