At Durham Nephrology Associates, we are always looking for ways to improve the quality of care our dialysis patients receive. That commitment is why we are introducing hemodiafiltration (HDF) at two of our clinics, South Durham and West Pettigrew. If you or a loved one receives dialysis at either of these locations, you may already be hearing about this treatment from your care team. Here is what you should know.
What Is Hemodiafiltration?
Hemodiafiltration is an advanced form of dialysis that builds on the process patients already know from standard hemodialysis. In conventional hemodialysis, a machine filters waste products and excess fluid from the blood via diffusion, in which toxins move across a semipermeable membrane from an area of high concentration to an area of low concentration.
HDF adds a second mechanism to this process, known as convection. During convection, fluid is pushed across the dialysis membrane under pressure, carrying waste particles along. This combination of diffusion and convection allows HDF to remove a broader range of toxins than standard hemodialysis alone, including some of the larger “middle molecules” that traditional dialysis is less effective at clearing. The treatment uses the same vascular access patients already have, so no additional procedure is required to begin HDF.
How Is HDF Different from Standard Hemodialysis?
The core difference comes down to what each method can remove from the bloodstream. Standard hemodialysis is effective at clearing small toxin particles, but middle-sized molecules that build up in the body of a person with kidney failure are harder to filter out through diffusion alone. HDF’s convective process is designed to reach these molecules more effectively, which is why researchers and clinicians have been studying its benefits for kidney patients for more than a decade, particularly in Europe, where high-volume HDF has been used successfully for years.
In the United States, this technology is newer. Following FDA clearance of updated dialysis equipment, clinics have begun offering high-volume HDF to patients who may benefit from more thorough toxin and fluid removal. Durham Nephrology Associates is proud to bring this option to our South Durham and West Pettigrew patients as part of our ongoing effort to keep pace with advances in kidney care.
What Are the Potential Benefits for Patients?
Every patient responds differently to treatment, and your nephrologist can help you understand what to expect based on your individual health needs. That said, clinical research on HDF has shown several potential benefits over time, including improved blood pressure control during treatment, reduced inflammation, fewer muscle cramps, and better fluid balance management between sessions. Some studies have also associated HDF with lower rates of hospitalization and cardiovascular complications when patients are able to consistently receive the full prescribed treatment.
It is worth noting that these benefits tend to develop over weeks and months of treatment, not immediately. Sticking to your full dialysis schedule, whether you are on HDF or standard hemodialysis, remains one of the most important things you can do for your health.
What Should Patients at South Durham and West Pettigrew Expect?
If you receive treatment at either of these clinics, your care team will talk with you directly about whether HDF is an appropriate option for your treatment plan. Not every patient is a candidate for HDF, and your nephrologist will consider your overall health, your vascular access, and your treatment history before making a recommendation.
For patients who do transition to HDF, the day-to-day experience of coming in for dialysis will look familiar. Sessions are still typically scheduled three times a week, for about four hours each. The main difference happens within the machine itself, as it performs the additional convective filtration step alongside standard diffusion.
Why Durham Nephrology Chose to Bring HDF to These Two Clinics
Introducing a new dialysis modality is not a decision our practice makes lightly. Before offering HDF at South Durham and West Pettigrew, our physicians reviewed the clinical research on convective therapies, including data from long-term use in Europe and more recent findings from clinics in the United States that have adopted the same technology. That research consistently pointed to the same conclusion: for appropriate patients, adding convection to the standard diffusion process can improve how thoroughly the blood is cleared of waste, without changing the basic routine patients are already used to.
We also considered the practical side of this decision. Both South Durham and West Pettigrew have the staff training and equipment needed to support HDF safely, and both clinics see a patient population that includes individuals who may benefit from more thorough middle-molecule clearance. Rather than introducing this treatment everywhere at once, we started with these two locations so our teams could build experience and refine our processes before considering a wider rollout.
Common Questions Patients Ask About HDF
Patients understandably have a lot of questions when a new treatment option is introduced, and our staff hears many of the same ones repeatedly. Below are a few we want to address directly.
Will switching to HDF change how often I need to come in for treatment? In most cases, no. HDF is typically delivered on the same three-times-weekly schedule as standard hemodialysis, and each session generally lasts about the same length of time.
Is HDF more uncomfortable than standard dialysis? No. The treatment uses the same needles and vascular access as conventional hemodialysis. Patients undergoing HDF often report feeling the same during treatment, with many noting improvements in how they feel in the hours and days afterward as their body adjusts.
Will my insurance cover HDF? Coverage can vary depending on your specific plan. Our billing staff can help you understand what your insurance will cover before you begin treatment, and your nephrologist can help determine whether HDF is medically appropriate for your case.
How will I know if HDF is working better for me than standard hemodialysis? Your care team will continue to monitor your lab results, blood pressure, and overall symptoms at each visit, just as they do now. Any changes in these measures over time will help your nephrologist assess whether HDF is providing the intended benefit.
What This Means for the Future of Care at Durham Nephrology
Bringing hemodiafiltration to South Durham and West Pettigrew reflects a broader commitment at Durham Nephrology Associates to offering our patients access to treatments backed by solid clinical evidence, not simply the newest technology available. As more data becomes available from clinics using this therapy across the country, we will continue to evaluate whether expanding HDF to additional locations makes sense for our patient population.
In the meantime, our focus remains on making sure that patients at South Durham and West Pettigrew who begin HDF are fully supported through the transition, with clear communication from their care team about what to expect and how their treatment plan may be adjusted along the way.
Our Providers Are Here to Guide You
Decisions about your dialysis treatment should always be made in partnership with your care team. The physicians and advanced practice providers at Durham Nephrology Associates, along with our physician assistants and nurse practitioners, work closely with dialysis staff at each clinic to monitor patients’ responses to treatment and make adjustments as needed. Our goal is to make sure that any change to your care, including a move to a newer treatment like HDF, is made thoughtfully and with your specific health needs in mind.
We understand that hearing about a new treatment option can raise questions, and that is exactly what your care team is here for. Whether you want to know if HDF is right for you, or you simply want to understand more about how your current treatment works, do not hesitate to bring your questions to your next appointment.
Have Questions About Hemodiafiltration?
If you are a patient at our South Durham or West Pettigrew clinics and want to learn more about hemodiafiltration, talk with your nephrologist at your next visit or contact our office to schedule a conversation with your care team. Durham Nephrology Associates is committed to keeping our patients informed about the treatments available to them and to providing care that reflects the latest advances in kidney health. Reach out to us today to learn more about how HDF could impact your treatment plan.
