Hemodiafiltration in Neonates: Narrative Review Maps Applications but Reports No Clinical OutcomesHemodiafiltration in Babies: What We Still Do Not Know

BackgroundMultiple organ dysfunction syndrome (MODS) remains a major challenge in the intensive care of neonates and infants and is associated with substantial morbidity and mortality, particularly in the presence of sepsis and acute kidney injury. Conventional kidney replacement and detoxification strategies may be difficult to implement in neonates and low-weight infants because of technical and physiological limitations. Hemodiafiltration (HDF), which combines convective and diffusive clearance mechanisms, has emerged as a potential extracorporeal support modality for metabolic and inflammatory control while maintaining hemodynamic stability.ObjectiveTo provide a structured narrative review of the available literature on the clinical applications, potential benefits, safety considerations, and technical aspects of hemodiafiltration in neonates and infants with multiple organ dysfunction syndrome.MethodsThis study was conducted as a structured narrative review with systematic search elements. PubMed, Scopus, Web of Science, and the Cochrane Library were searched for publications from January 2018 to October 2025. Earlier landmark publications identified through reference-list screening were additionally included to provide historical and technical context. A structured search and descriptive selection process was used to identify publications relevant to extracorporeal blood purification in neonates and infants. Eligible populations included neonates (