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  • Vernooij, Robin W.M.University Medical Center Utrecht (author)

High-Target Hemodiafiltration Convective Dose Achieved in Most Patients in a 6-Month Intermediary Analysis of the CONVINCE Randomized Controlled Trial

  • Article/chapterEnglish2023

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  • 2023
  • 8 s.

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  • LIBRIS-ID:oai:lup.lub.lu.se:1af7bc56-69d0-40ce-8230-5e548cd04751
  • https://lup.lub.lu.se/record/1af7bc56-69d0-40ce-8230-5e548cd04751URI
  • https://doi.org/10.1016/j.ekir.2023.08.004DOI

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  • Language:English
  • Summary in:English

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  • Subject category:art swepub-publicationtype
  • Subject category:ref swepub-contenttype

Notes

  • Introduction: High convection volumes in hemodiafiltration (HDF) result in improved survival; however, it remains unclear whether it is achievable in all patients. Methods: CONVINCE, a randomized controlled trial, randomized patients with end-stage kidney disease 1:1 to high-dose HDF versus high-flux hemodialysis (HD) continuation. We evaluated the proportion of patients achieving high-dose HDF target: convection volume per visit of ≥23 l (range ±1 l) at baseline, month 3, and month 6. We compared baseline characteristics in the following 2 ways: (i) patients on target for all 3 visits versus patients who missed target on ≥1 visits and (ii) patients on target for all 3 visits or missing it once versus patients who missed target on ≥2 visits. Results: A total of 653 patients were randomized to HDF. Their mean age was 62.2 (SD 13.5) years, 36% were female, 81% had fistula vascular access, and 33% had diabetes. Across the 3 visits, 75 patients (11%), 27 patients (4%), and 11 patients (2%) missed the convection volume target once, twice, and thrice, respectively. Apart from diabetes, there were no apparent differences in patient characteristics between patients who always achieved the high-dose target (83%) and those who missed the target either once or more (17%) or twice or more (6%). Conclusion: Achieving high-dose HDF is feasible for nearly all patients in CONVINCE and could be maintained during the 6-month follow-up period. Apart from diabetes, there were no other indications for confounding by indication on multivariable analyses that may explain the potential survival advantage for patients receiving high-dose HDF.

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  • Hockham, C.Imperial College London (author)
  • Barth, C. (author)
  • Canaud, B.University of Montpellier (author)
  • Cromm, K.Fresenius Medical Care Deutschland GmbH (author)
  • Davenport, A.University College London (author)
  • Hegbrant, J.Lund University,Lunds universitet,Njurmedicin,Sektion II,Institutionen för kliniska vetenskaper, Lund,Medicinska fakulteten,Nephrology,Section II,Department of Clinical Sciences, Lund,Faculty of Medicine(Swepub:lu)jo0134he (author)
  • Rose, M.Berlin Institute of Health (BIH),Charité - University Medicine Berlin (author)
  • Strippoli, G. F.M.University of Sydney,University of Bari Aldo Moro (author)
  • Török, M. (author)
  • Woodward, M.Imperial College London,University of New South Wales (author)
  • Bots, M. L.University Medical Center Utrecht (author)
  • Blankestijn, P. J.University Medical Center Utrecht (author)
  • University Medical Center UtrechtImperial College London (creator_code:org_t)

Related titles

  • In:Kidney International Reports8:11, s. 2276-22832468-0249

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