DaVita Rapidly Scales Expanded HD to Target Hard-to-Remove Toxins

In the ongoing pursuit of improved outcomes in kidney care, few targets have been as stubborn as the middle molecule gap. When middle molecules — larger uremic toxins that are not effectively cleared during standard high-flux dialysis — accumulate, they can actively drive chronic inflammation and cardiovascular complications, and saddle patients with symptom burden, including poor sleep quality, itchiness and restless leg syndrome.

With advanced treatments, including Expanded hemodialysis (Expanded HD) and hemodiafiltration (HDF) becoming more available in the U.S., DaVita is now working to scale access to advanced middle molecule clearance as quickly as possible.

The catalyst for DaVita’s rollout is the recent FDA approval of Nipro’s ELISIO-HX dialyzer. This new dialyzer enables Expanded HD and is designed to remove more middle molecules during treatment while safely retaining essential proteins. This specialized filter fits into existing dialysis machines, creating the opportunity to rapidly implement the technology.

For nephrologists across the country, this translates into faster access to a powerful, evidence-based therapy designed to clear a much broader spectrum of toxins and a new way to elevate and personalize patient care. DaVita will also continue its pilots of HDF and other Expanded HD dialyzers to continue advancing care into the future.

More Options for Personalized Kidney Care

Until recently, access to Expanded HD and HDF in the U.S. has been limited. However, a growing body of research confirms that both therapies can achieve greater removal of middle molecules than high-flux dialysis while maintaining strong safety profiles.^{1, 2, 3, 4}

The FDA approval of Nipro’s ELISIO-HX dialyzer creates an opportunity for DaVita to accelerate access to enhanced middle molecule clearance. Because the newly approved dialyzer is compatible with high-flux hemodialysis machines, providers can implement the therapy without waiting for new equipment or significant changes to center operations.

 “The challenge with many healthcare innovations is the time it takes to translate promising therapies into meaningful patient access, and DaVita is bridging that gap today,” says Jeff Giullian, MD, chief medical officer for DaVita. “We are putting an evidence-based clinical advancement directly into the hands of nephrologists and care teams as quickly as possible — to empower them to elevate patient care immediately without disrupting how care is delivered.”

Innovation in kidney care is not only about developing new technologies. It is also about making proven advancements more accessible to the patients who may benefit from them.

The approval of ELISIO-HX adds another option for delivering Expanded hemodialysis in the United States, helping increase access to therapies designed to remove a broader range of toxins than high-flux dialysis.

While DaVita expands access to Expanded HD rapidly, the care provider will continue to pursue all middle molecule clearance innovations and evaluate the impact of new technologies within the U.S. clinical landscape.

“We will remain focused on what delivers the greatest benefit for patients,” Dr. Giullian explains. “Expanded HD offers the ability to rapidly scale access to enhanced middle molecule clearance, and we remain open to all approaches to middle molecule clearance for future use. Our goal remains constant: equipping nephrologists with the ability to advance clinical care and take the next step in improving patients’ clinical outcomes and quality of life.”