Hemodiafiltration versus High-Flux Hemodialysis and Risk of Mortality: A Multinational Target Trial Emulation.

Among 19,539 eligible patients at day 91, inverse probability weighting created a weighted pseudopopulation of 19,758 patients (8641 HDF; 11,117 hemodialysis). During a median follow-up of 16 months (interquartile range, 6-32), 4282 deaths occurred. HDF was associated with a lower risk of all-cause mortality compared with high-flux hemodialysis (hazard ratio, 0.72; 95% confidence interval, 0.67 to 0.77). In this large multinational target trial emulation, sustained high-volume postdilution HDF was associated with lower mortality than high-flux hemodialysis.