The National Institute for Health and Care Excellence (NICE) in England has published new Renal Replacement Therapy (RRT) Guidelines1

The NICE guidelines offer evidence-based recommendations with the aim to promote individualised and integrated care in England. By formally assessing the cost-effectiveness of an intervention, service or programme, decision-makers ensure that maximum gain is achieved from limited resources.

NICE* states to consider in-centre HDF rather than in-centre HD (hospital or satellite unit)

In order to provide evidence-based guidance, NICE systematically reviewed best available renal replacement therapy studies and conducted an economic evaluation. The assessment identified clear benefits of HDF treatment for both renal disease patients and the National Health Service (NHS), as HDF is considered cost-effective and is expected to decrease mortality rates among patients.

HDF versus HD: Clinical benefits


  • Considered greater survival benefit of HDF over HD
  • Survival benefits could be increased if patients are started on in-centre HDF as soon as they required RRT

Convection Volume:

  • The NICE committee did not make any specific recommendations, but agreed that it was likely that patients who achieved higher convection volumes would get a greater benefit from HDF.

Fewer side effects for HDF compared to HD

HDF versus HD: Cost-effectiveness analysis

  • HDF is as cost-effective compared to HD
  • Reduced EPO requirements of 9% with HDF based on weighted average calculation
  • Economic benefits for units using Fresenius 5008 series as no switching costs from HD to HDF (including higher convection volumes) which means neutral budget impact

Fresenius Medical Care delivers HDF

At Fresenius Medical Care, we have a long-standing commitment to make HDF available to all patients aiming to achieve the best possible outcome. Fresenius Medical Care has developed innovative technologies to make HDF as simple and convenient as HD and automatically maximize substitution rates with AutoSub plus in HDF to support the application of HighVolumeHDF.

1, Renal replacement therapy and conservative management, published date: October 2018
*All statements and assessments by NICE are based on care practice and costs in England.