The Evolution of Hemodialysis in Chile: Is Hemodiafiltration the Next Step?

Hemodialysis began in Chile during the latter half of the 20th century, primarily targeting individuals with acute renal failure. With time, dialysis facilities emerged across diverse regions of the nation, covering hospitals and private centers. This expansion widened dialysis access to chronic patients, culminating in universal coverage through the AUGE plan. Ongoing technological improvements and the integration of pharmaceutical interventions for chronic kidney disease-related complications have notably enhanced survival rates. Nonetheless, dialysis recipients continue to confront significantly elevated mortality risks in comparison to the general population. Despite advancements, complications linked to dialysis persist, significantly affecting patients' overall quality of life. Heightened rates of hospitalization and mortality are, in part, ascribed to the inherent technical limitations of hemodialysis in efficiently clearing uremic toxins. Therefore, superior purification modalities such as high-volume hemodiafiltration need to be progressively adopted to effectively address the persistent clinical needs in the care of dialysis patients within the Chilean context.