Success in Achieving Relatively High Targeted Convection Volumes in Multi‐Ethnic Individuals Receiving Hemodiafiltration in Singapore

ABSTRACT

Background
Hemodiafiltration has demonstrated improved outcomes in end‐stage kidney disease, particularly with higher convection volumes than conventional hemodialysis. However, data on multiethnic Asian populations remain limited. This study evaluated the feasibility of achieving relatively high targeted convection volumes in hemodiafiltration in patients with end‐stage kidney disease in Singapore.


Methods
This retrospective cohort analysis included 1404 patients undergoing hemodiafiltration between 2019 and 2023 at Fresenius Kidney Care clinics in Singapore using data obtained from the EuCliD database. Patients aged ≥ 18 years and on hemodiafiltration for > 3 months were included. Multivariate regression models were used to assess the factors associated with the attainment of convection volume.


Results

Over 291,000 hemodiafiltration sessions were analyzed. The mean convection volumes achieved were 21.8 L in post‐dilution and 40.8 L in pre‐dilution mode. Higher blood flow rates and treatment durations were significantly associated with relatively high targeted convection volume (
p
 < 0.001). The distribution of convection volume was similar among Chinese, Indian, and Malay patients. Ethnicity, age, and vascular access were not significant predictors. Approximately 29% of the variation in achieved convection volume was attributable to center‐related factors.



Conclusion
Relatively high targeted convection volume in hemodiafiltration was consistently achieved across a multiethnic cohort in Singapore. These findings support the feasibility of delivering high‐volume hemodiafiltration to diverse real‐world settings.