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McALLEN — The Rio Grande Valley is among the first areas in the U.S. selected to introduce a new treatment for kidney disease known as hemodiafiltration, or HDF, an advanced form of dialysis that filters slightly larger toxins than conventional dialysis.
Fresenius Kidney Care clinics across the country are working on implementing high volume HDF technology in their dialysis units.
According to the National Institute of Diabetes and Digestive and Kidney Diseases, in 2023 there were over 800,000 patients across the county with end stage kidney disease with 68% of patients on dialysis and 32% receiving a kidney transplant.
Of that number, there are about 80,000 patients with the disease in Texas with about 8,860 patients waiting for a kidney transplant by November 2024, according to Kidney Texas Inc.
Dr. Salil Mangi, a nephrologist at South Texas Kidney Specialists, explained that although the technology has been around for about 15 to 20 years in Europe, it’s only now making its way to the U.S.
He explained that when a patient has renal failure or kidney disease their body is unable to filter molecular toxins which he broke down into three different sizes: those being small, medium and larger toxins.
Conventional dialysis is only able to remove “small” toxins from the blood using a filtration membrane that runs a patient’s blood on one side and a cleaning solution on the other side.
Throughout that process, the blood goes through a diffusion which moves high toxin concentration from the blood to the solution.
HDF on the other hand is a hybrid system that incorporates conventional dialysis combined with a diafiltration process to to remove smaller and medium toxins.
Mangi explained the diafiltration process is done through convection which moves particles by pushing water and waste through a filter using a pressure difference.
“You have to use the system called high volume because you need to remove at least 23 liters of fluid from the patient and give it back to them in order for this to work well,” Mangi said.
Mangi explained HDF is just a new and improved system. However, patients will still have to go to the dialysis center to receive treatment.
“The amount of time is the same, you still do exactly the same thing like you do when you go to conventional dialysis except that these machines are different (and) the filters that we use are different,” Mangi said.
He added that anybody who qualifies for dialysis, qualifies for this technology if it’s available in the dialysis units that they go to.
The company began phasing in the treatment a few months ago, but once all the Fresenius Kidney Care clinics are enrolled there should be more than 1,000 patients in Hidalgo and Starr counties who will receive the treatment.
Although the technology is barely making its way to the states, studies from Europe have found that patients who undergo HDF have a 23% higher survival rate than those on conventional dialysis.
Other studies have found that it also reduces the number of days a patient is hospitalized as well as helps patients experience fewer side effects such as muscle cramps and cognitive issues.
The company will be doing its own studies in hopes it can reproduce the same results seen in Europe.
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