A study by Brazilian researchers found that hemofiltration (HDF), the most advanced renal replacement therapy method, reduces the risk of death by 68% among patients treated exclusively by the Unified Health System (SUS).
The work, called BRIGHT-HD, was published in June in the scientific journal Journal of Clinical Medicine and is the first in the country to demonstrate survival gains using blood filtration in the general network.
The analysis collected data from 369 patients followed between 2022 and 2024 at centers in São Paulo and Vale do Paraíba. Of this total, 321 people were on conventional dialysis, while 48 people were receiving hemofiltration therapy.
Even after adjusting for factors such as age, diabetes and type of vascular access, the group that underwent the more modern technique had a lower death rate.
Obstacles to expanding the use of this technology
Experts from the University of São Paulo (USP), Associação Educacional Nove de Julho (UNINOVE), Fundação Lia Maria Aguiar, and Nefrostar participated in the study.
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The authors state that the results reinforce the clinical effectiveness of hemofiltration also in the context of a standardized regimen, where its adoption remains limited. The main drawback is the infrastructure needed for this procedure, which relies on highly purified water, with more stringent microbiological and endotoxin control standards.
RDC 11/2014, which regulates dialysis services, does not differentiate water quality standards between dialysis and hemofiltration, making it difficult to establish specific structures for this technology in the public network. As a result, most services do not offer this method, despite the demonstrated benefits.
The researchers state that the findings reinforce the need to discuss expanding access to blood filtration in the public system. According to them, wider adoption of this technique has the potential to improve the life expectancy of chronic kidney disease patients being treated in the country.
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