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    What Is In-Center Hemodiafiltration?

    Reviewed by Medical Contributor Dinesh K. Chatoth, MD, FASN on May 27, 2025.
    Hemodiafiltration (HDF) is the optimal in-center treatment for kidney failure, also called end stage renal disease (ESRD). This advanced treatment combines hemodialysis with an additional filtration process, called hemofiltration (HF), to remove waste, toxins, and excess fluid. HDF cleans your blood better so you can feel better—right after treatment and beyond.

    How does in-center hemodiafiltration work?

    If you choose in-center HDF, you'll typically go to a kidney dialysis center 3 times per week for about 4 hours each visit. Your doctor will prescribe your treatment based on your unique needs. Staying for your full HDF session each time will help you get the most out of treatment.

    How does in-center hemodiafiltration work

    During your HDF treatment, you will be connected to the dialysis machine through your dialysis access. Just like your current HD treatment, a semi-permeable membrane called a dialyzer will remove small particle toxins from your blood by diffusion. With HDF, pressure is also added to push your blood through the dialyzer removing more middle-sized particle toxins and excess fluid—a process known as convection. Substitution fluid is used to help maintain fluid balance during this process.

    Your care team will be there to supervise your treatments, help you transition from HD to HDF, and provide support throughout your treatment.

    What are the benefits of HDF?
    HDF uses both hemodialysis and hemofiltration to remove more waste, toxins, and fluids, while preserving more albumin. Because hemodiafiltration cleans your blood better, you may start to feel better and see some of these potential benefits:

    • Longer life
    • More energy
    • Better sleep
    • Less mental decline
    • Less recovery time after treatment
    • Improved overall health
    Hemodialysis partner.

    Talking to your doctor about HDF

    Your doctor can help you better understand hemodiafiltration and whether it's right for you. Here are 5 topics to cover at your next appointment:

    • How HDF could support your treatment goals
    • Any access considerations for doing HDF
    • What would change from your current treatment
    • How you can expect to feel after HDF
    • Ways your health can improve with HDF

    Answers to common questions about hemodiafiltration

    HDF is the optimal in-center treatment option for most people with ESRD. When home dialysis is not a good option, HDF is an advanced treatment that may offer potential added benefits while still being performed in-center, just like traditional hemodialysis. Talk to your doctor and ask if HDF is right for you.

    Yes, most people doing in-center hemodialysis (HD) can do HDF. Talk to your doctor about whether switching is right for you and when hemodiafiltration will be available at your dialysis center. It will take a few weeks to transition from HD to HDF.

    Good news. Hemodiafiltration uses the same access type as standard hemodialysis. If you have questions about your access site, reach out to your doctor and make sure you have the best access for you.

    There are a few things you can do to get the most benefit from your hemodiafiltration treatment. First, follow your treatment schedule exactly as your doctor prescribes. Staying for the full treatment will help you feel your best. Following your care team's instructions on eating well, limiting fluids, and taking medications as prescribed will also help.
    Eduardo
    “My son's mom noticed that I've been going out more and spending more time with them.”
    — Eduardo

    On HDF
    Watch his story
    Nikolaos
    “I try it, and I see in a couple of weeks that I feel better. I'm at my best.”
    — Nikolaos
    On HDF
    Watch his story
    A chronic kidney disease screening.
    Feel the full benefits of HDF. Stay for your full treatment time, every time.
    Completing your treatment as prescribed helps reduce the buildup of toxins, waste, and fluid in your blood between treatments. This can mean more energy after and between treatments, plus fewer hospitalizations.
    A chronic kidney disease screening.
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