Clinical Application of Haemoadsorption in Maintenance Haemodialysis Patients: An Adapted English Republication of the Chinese HA-MHD Consensus

The accumulation of protein-bound uraemic toxins and middle- to large-molecular-weight toxins in maintenance haemodialysis (MHD) patients is results in long-term complications. Haemoadsorption (HA) can efficiently remove these uraemic toxins and reduce the risk of long-term complications in MHD patients. The Chinese HA-MHD Consensus Working Group has revised and updated the 2021 Shanghai Expert Consensus on the Clinical Application of Haemoadsorption in Maintenance Haemodialysis Patients to further standardize clinical application of HA and reflect the latest evidence. Based on an extensive literature search, the Grading of Recommendations Assessment, Development and Evaluation framework, and the modified Delphi method, the working group formulated 27 evidence-based recommendations regarding patient populations, session frequency, treatment modalities, precautions, and adverse reactions. This consensus systematically delineates the clinical thresholds and rationales for utilizing HA across three core dimensions: routine treatment regimens, intensive treatment regimens, and long-term complication risk management to provide comprehensive guidance. Furthermore, the consensus provides detailed guidance on individualized operational parameters to maximize both safety and treatment efficacy. This consensus aims to provide the latest guiding opinions for the rational and standardized application of HA therapy in MHD patients.