Comparison of mortality in ESRD patients on convective and diffusive extracorporeal treatments

Locatelli, Francesco; Marcelli, Daniele; Conte, Ferruccio; Limido, Aurelio; Malberti, Fabio; Spotti, D.

doi:10.1046/j.1523-1755.1999.00236.x

Cited by 207 publications

(128 citation statements)

References 27 publications

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“…Enhanced middle molecule clearance has other benefits. Previous studies demonstrated improved ␤2-microglobulin clearance by HDF (11,25,26), and one retrospective study suggested that convective dialysis treatments reduce the incidence of carpal tunnel syndrome (27).…”

Section: Discussionmentioning

confidence: 99%

Long-Term Outcomes in Online Hemodiafiltration and High-Flux Hemodialysis

Vilar

Fry

Wellsted

et al. 2009

Clinical Journal of the American Society of Nephrology

148

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Section: Discussionmentioning

confidence: 99%

Long-Term Outcomes in Online Hemodiafiltration and High-Flux Hemodialysis

Vilar

Fry

Wellsted

et al. 2009

Clinical Journal of the American Society of Nephrology

148

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“…16,17 The results of previous studies that evaluated the possible clinical advantages of HDF in comparison with HD are not consistent, and it is not possible to make any precise conclusion out of them. [17][18][19][20][21] Compared with low-flux dialysis, high-flux HD might have a beneficial effect on mortality and clinical outcomes in the patients [22][23][24][25][26][27] or not. 28 The use of synthetic high-flux membranes should be considered to delay the longterm complication of HD therapy: amyloidosis, hyperphosphatemia, cardiovascular risk, and anemia.…”

Section: Introductionmentioning

confidence: 99%

Influence of Dialysis Modality and Membrane Flux on Quality of Life in Hemodialysis Patients

Knežević¹,

Djordjević²,

Radovanovic-Velickovic³

et al. 2012

Renal Failure

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Background: The quality of life in patients undergoing hemodialysis is significantly disturbed. There are data that hemodiafiltration (HDF) may be more effective than conventional hemodialysis in the removal of uremic toxins and may reduce frequency and severity of intradialytic and postdialysis adverse symptoms in patients. Also, some researchers suggest advantages of using high-flux membranes compared with low-flux. Objective: The aim of this study was to examine whether hemodialysis modality and membrane flux, independent of membrane biocompatibility, make differences in quality of life in patients. Methods: In our cross-sectional study, we evaluated 124 patients who were divided, based on therapy, into three groups: online HDF, high-flux hemodialysis, and low-flux hemodialysis. Data were collected using the Short Form-36 questionnaire combined with special questionnaire, which included demographic and clinically related questions. Results: Health-related quality of life was better in patients on HDF compared with patients on hemodialysis, especially compared with low-flux hemodialysis patients in most of the scales and in both dimensions: physical component scale and mental component scale. There were no statistically significant differences in Short Form-36 domains between high-flux hemodialysis and low-flux hemodialysis. Conclusion: Our data suggest the potential advantages of HDF with regard to influence on quality of life, which is sufficient to justify further research in prospective and longitudinal study design.

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“…3,4 Observational studies have consistently suggested that high-flux treatments for long-term dialysis patients with stage 5 CKD are associated with reduced morbidity and mortality. [5][6][7][8] The Hemodialysis (HEMO) Study, 9 a landmark randomized, controlled trial designed to test the effect of membrane flux and dialysis dosage on mortality, showed that high-flux HD is associated with a nonsignificantly lower relative mortality risk of 8%, although a secondary analysis suggested a significant advantage of highflux membranes in patient subgroups. More recently, the Membrane Permeability Outcome (MPO) study 10 found that survival could be significantly improved by using high-flux as compared with low-flux membranes in high-risk patients identified by serum albumin of Յ4 g/dl as well as in patients with diabetes in a post hoc analysis.…”

mentioning

confidence: 99%

Hemofiltration and Hemodiafiltration Reduce Intradialytic Hypotension in ESRD

Locatelli

Altieri

Andrulli

et al. 2010

Journal of the American Society of Nephrology

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244

192

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Symptomatic intradialytic hypotension is a common complication of hemodialysis (HD). The application of convective therapies to the outpatient setting may improve outcomes, including intradialytic hypotension. In this multicenter, open-label, randomized controlled study, we randomly assigned 146 long-term dialysis patients to HD (n ϭ 70), online predilution hemofiltration (HF; n ϭ 36), or online predilution hemodiafiltration (HDF; n ϭ 40). The primary end point was the frequency of intradialytic symptomatic hypotension (ISH). Compared with the run-in period, the frequency of sessions with ISH during the evaluation period increased for HD (7.1 to 7.9%) and decreased for both HF (9.8 to 8.0%) and HDF (10.6 to 5.2%) (P Ͻ 0.001). Mean predialysis systolic BP increased by 4.2 mmHg among those who were assigned to HDF compared with decreases of 0.6 and 1.8 mmHg among those who were assigned to HD and HF, respectively (P ϭ 0.038). Multivariate logistic regression demonstrated significant risk reductions in ISH for both HF (odds ratio 0.69; 95% confidence interval 0.51 to 0.92) and HDF (odds ratio 0.46, 95% confidence interval 0.33 to 0.63). There was a trend toward higher dropout for those who were assigned to HF (P ϭ 0.107). In conclusion, compared with conventional HD, convective therapies (HDF and HF) reduce ISH in long-term dialysis patients.

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Comparison of mortality in ESRD patients on convective and diffusive extracorporeal treatments

Cited by 207 publications

References 27 publications

Long-Term Outcomes in Online Hemodiafiltration and High-Flux Hemodialysis

Long-Term Outcomes in Online Hemodiafiltration and High-Flux Hemodialysis

Influence of Dialysis Modality and Membrane Flux on Quality of Life in Hemodialysis Patients

Hemofiltration and Hemodiafiltration Reduce Intradialytic Hypotension in ESRD

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