Comparison of Fracture Risk among End-Stage Renal Disease Patients on Online Hemodiafiltration versus High flux Hemodialysis | ||||
| ARCADEs of MEDICINE | ||||
| Articles in Press, Accepted Manuscript, Available Online from 19 August 2025 | ||||
| Document Type: Original Research | ||||
| DOI: 10.21608/arcmed.2025.401878.1145 | ||||
 View on SCiNiTO | ||||
| Authors | ||||
Hamdy Saad Taha Ali  1; Hany Hafez Lotfy2; Khaled Gouda Abdelwahab3; Maha Abdelmoneim Said3
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| 1Nephrology Department, Armed Forces College of Medicine (AFCM), Cairo, Egypt. | ||||
| 2Radiology and Medical Imaging Department, Military Medical Academy, Cairo, Egypt | ||||
| 3Internal Medicine and Nephrology Department, Armed Forces College of Medicine, Cairo, Egypt | ||||
| Abstract | ||||
| Background: Chronic kidney disease mineral and bone disorder contributes significantly to morbidity, mortality, and fracture risk (FRAX) in end-stage renal disease (ESRD) patients. Hemodiafiltration (HDF) may offer metabolic bone benefits over high-flux hemodialysis, but evidence remains inconclusive. The aim of this work was to contrast the FRAX of ESRD patients receiving high-flow hemodialysis with that of patients receiving online HDF. Methods: This Analytical Observational study was carried out on 72 patients who have been on regular hemodialysis for over a year and are in a stable clinical condition. Two groups were randomly assigned to the study participants, and their assignments were as follows: Group I underwent high flux hemodialysis (HF-HD), and Group II received online Hemodiafiltration (HDF). Results: Those individuals who had a history of bone fractures were significantly different from those who did not. Neck of Femur and Lumbar Vertebra T-scores were significantly lower in fracture patients. Patient fractures were also associated with a markedly reduced trabecular bone score. The fracture group also had a significantly higher FRAX score, which is a predictor of FRAX. (The significance level is less than 0.01.) Conclusions: HDF showed better dialysis efficiency but higher FRAX than HF-HD, despite similar bone metabolism markers. FRAX was correlated positively with age, cholesterol, and bone density. Study recommends regular bone health checks, tailored dialysis, and further research on HDF's long-term impact. | ||||
| Keywords | ||||
| Fracture Risk; End-Stage Renal Disease; Hemodiafiltration; High Reflux Hemodialysis | ||||
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