EXPANDED HEMODIALYSIS VERSUS ONLINE HEMODIAFILTRATION FOR MIDDLE-MOLECULE CLEARANCE: A SYSTEMATIC REVIEW AND META-ANALYSIS

Certificate Output Instructions

For best output, select "Paper Size" as "A4" and "Margin" as "0" or "None".

To save or print to PDF, please select Print Destination > Save as PDF, enable Background Graphics under "More Settings", then click "Save".

Presented the abstract " "
(Abstract co-author(s): )

Back

E-Poster Presentation

During the congress, E-Posters will be accessible to all participants on the congress website 24/7, as well as in the E-poster stations in the congress center.

Preparing your E-Poster

Please review the E-Poster format requirements carefully when preparing your E-Poster. Should your E-Poster not meet the mentioned requirements, it may not be displayed as described above.

E-Poster Submission Deadline

Please prepare and upload your E-Poster no later than March 14, 2026 11.59PM CET. After this date, you will no longer be able to prepare and upload your E-poster and it will not be displayed and accessible on the congress website.

E-Poster Format Requirements

PDF file
Layout: Portrait (vertical orientation)
One page only (Dim A4: 210 x 297mm or PPT)
E-Poster can be prepared in PowerPoint (one (1) PowerPoint slide) but must be saved and submitted as PDF file.
File Size: Maximum file size is 2 Megabytes (2 MB)
No hyperlinks, animated images, animations, and slide transitions
Language: English
Include your abstract number
E-posters can include QR codes, tables and photos

E-Poster

Abstract Title *

EXPANDED HEMODIALYSIS VERSUS ONLINE HEMODIAFILTRATION FOR MIDDLE-MOLECULE CLEARANCE: A SYSTEMATIC REVIEW AND META-ANALYSIS

Please follow the instructions below to input your abstract title.

Abstract titles should be brief and reflect the content of the abstract.

The title will not be accepted if it exceeds 25 words.
Type in CAPITAL LETTERS.
Lowercase may be used for abbreviations only, for example, mRNA.

Co-author 1

Omar Elkoumi omarelkoumi@gmail.com Suez University Faculty of Medicine Suez Egypt *

Co-author 2

Ahmed Elkoumi ahmedelkoumi@yahoo.com The Ministry of Health and Population Health Affairs Directorate of El Sharqeya El Sharqeya Egypt -

Co-author 3

Mariam Khaled Elbairy mariam.ksah@med.suezuni.edu.eg Suez University Faculty of Medicine Suez Egypt -

Co-author 4

Mohamed Hamouda Elkasaby mohamedhamouda2182000@gmail.com Al-Azhar University Faculty of Medicine Cairo Egypt -

Co-author 5

Ayah Abdulgadir Abdulgadirayah@gmail.com University of Khartoum Faculty of Medicine Khartoum Sudan -

Co-author 6

Co-author 7

Co-author 8

Co-author 9

Co-author 10

Co-author 11

Co-author 12

Co-author 13

Co-author 14

Co-author 15

Introduction

Expanded hemodialysis (HDx) and online hemodiafiltration (OL-HDF) are advanced dialysis modalities designed to enhance solute removal. The comparative efficacy of these techniques for middle- and small-molecule clearance remains uncertain. We conducted a systematic review and meta-analysis to compare clearance outcomes between HDx and OL-HDF quantitatively.

Methods

We searched PubMed, Scopus, Web of Science, and CENTRAL databases through October 2025 for studies comparing HDx and OL-HDF in adult patients. Ten studies (randomized and observational) were included. Standardized mean differences (SMD) and 95% confidence intervals (CIs) were pooled using a random-effects model (RevMan for Mac). Primary outcome: β2-microglobulin clearance. Secondary outcomes: myoglobin, urea, phosphate, and creatinine clearance. Heterogeneity was quantified with I².

Results

Ten studies with a total of 888 patients were included in the meta-analysis. OL-HDF demonstrated significantly better β2-microglobulin clearance compared with HDx (SMD −0.46 g/dL, 95% CI −0.79 to −0.13; p = 0.007; I² = 45%). No statistically significant differences were observed for myoglobin clearance (SMD −0.19 g/dL, 95% CI −1.87 to 1.49; p = 0.83). Urea clearance was similar between modalities (SMD −0.09 g/dL, 95% CI −0.28 to 0.10; p = 0.36; I² = 0%). Phosphate clearance showed no difference (SMD −0.15 g/dL, 95% CI −0.59 to 0.29; p = 0.49; I² = 0%). Creatinine clearance also did not differ significantly (SMD −0.10 g/dL, 95% CI −0.45 to 0.25; p = 0.57; I² = 0%).

Conclusion

OL-HDF provides superior β2-microglobulin clearance versus HDx, while clearance of myoglobin, urea, phosphate, and creatinine is comparable. These results support OL-HDF’s potential advantage for middle-molecule removal. Future large, standardized clinical trials are warranted to confirm these findings and to evaluate long-term clinical outcomes.

Kewords