Abstract / Summary
Hemodiafiltration (HDF) combines diffusive and convective clearance, enhancing the removal of uremic toxins, particularly middle molecules, compared with conventional hemodialysis (HD). Recent evidence, including meta-analyses and the CONVINCE trial, suggests that high-volume HDF is associated with improved clinical outcomes, particularly when adequate convective volumes are achieved. In Brazil, the expansion of this modality has been accompanied by studies demonstrating its feasibility, safety, and applicability across different clinical settings. This position statement from the Brazilian Society of Nephrology (SBN), educational rather than normative in nature, provides recommendations based on the best available evidence and expert consensus regarding the use of HDF in maintenance dialysis in Brazil. The document addresses patient selection, minimum prescription parameters, operational targets, technical and safety requirements, as well as ethical, regulatory, and economic aspects, with the aim of supporting clinical and managerial decision-making, reducing practice variability, and promoting safer, higher-quality dialysis care.