Brunot V, et al. - Researchers compared the performance of on-line automated predilution heparin-free hemodiafiltration (HDF) to that of conventional heparin-free hemodialysis (HD) with a heparin-coated membrane. They performed a prospective analysis of chronic hemodialysis patients at high risk of bleeding. Routine use of heparin-free HD and on-line HDF in these settings for 1 year was followed by a comparison of HDF to HD, using a propensity score, regarding session failure and efficiency. They found that in chronic hemodialysis patients with increased bleeding risk, safety as well as the efficacy of heparin-free on-line predilutional HDF was obviously reflected in findings. The strong contributors to the observed performance included the use of an automatic substitution volume that avoids filters hemoconcentration and of a blood flow above 250 mL/min.