Preface

Chapter 9 **Cost-Effectiveness of Online Hemodiafiltration 141**

Khalid AlSaran and Khalid Mirza

**VI** Contents

Hemodialysis (HD) treatment had over many years improved the survival rate of patients with end-stage renal disease (ESRD). However, standard or conventional HD prescription is far from being optimal in replacing the function of normal kidneys. Its unphysiologic clear‐ ance pattern and inability to remove all types and sizes of uremic toxins result in inter- and intra-dialysis complications and unacceptable high rates of cardiovascular morbidity and mortality. Hemodiafiltration (HDF), which had attracted much attention in recent years as an optimum modality of HD, offers the most physiologic clearance profile for a broad range of small-, medium-, and large-sized toxic molecules. Implementation of HDF can result in quality care achievements in clinical practice and reduction in morbidity and mortality rates among HD patients. This *Advances in Hemodiafiltration* book, with its wide coverage of vari‐ ous aspects of HDF, can be considered as a guide to the daily practice and how best possible medical outcomes can be achieved in dialysis patients. The tremendous efforts and valued contributions of all participating authors are much appreciated.

Finally, my special thanks and appreciation go to the Publishing Process Manager, Ms. Daja‐ na Pemac, for her great organization efforts and professional assistance.

> **Ayman Karkar** consultant physician and nephrologist Ministry of Health, Saudi Arabia
