Effects of online hemodiafiltration on anemia and nutritional status in chronic hemodialysis patients

Lee, Yu Ho; Shin, Yoon Soo; Lee, So Young; Kim, Yang‐Gyun; Lee, Sang Ho; Moon, Ju Young; Jeong, Kyung Hwan; Hwang, Hyeon Seok; Ahn, Shin Young; Lee, Hong Joo; Lee, Dong Hoon; Ko, Eun Jung; Cho, Hye Jeong; Yang, Dong Ho; Jeong, Hye Yun

doi:10.23876/j.krcp.19.082

Cited by 11 publications

(12 citation statements)

References 34 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…In this work we didn't find any difference between both groups as regard blood hemoglobin levels. This is against Lee et al (13) , who showed significant improvement in blood hemoglobin level in online HDF group compared to high flux HD, which may be attributed to longer duration (24 months) and larger sample size.…”

Section: Discussioncontrasting

confidence: 70%

Effect of Dialysis Modality on Bone Disease in Patient with End Stage Renal Disease

Alwahab

Anwar

Elnasier

et al. 2021

The Egyptian Journal of Hospital Medicine

View full text Add to dashboard Cite

Background: The kidney has an important effect on minerals and bone metabolism in humans. Kidney is the target organ of many regulating hormones such as parathyroid hormone (PTH) and fibroblast growth factor-23 (FGF-23), also it activates vitamin D. Abnormalities in phosphorus, calcium, vitamin D and parathyroid hormone are common in patients with chronic kidney disease (CKD). Objective: To compare the effect of online hemodiafiltration (HDF) dialysis versus high flux hemodialysis on bone markers. Patients and Methods: The study was performed on 50 prevalent hemodialysis (HD) patients in Ain Shams University Specialized Hospital on high flux dialysis and were divided into 2 groups (group 1), 25 patients who continued hemodialysis with high flux dialyzer and (group 2), 25 patients who were shifted to online HDF. Bone specific alkaline phosphatase (BSAP), calcium, phosphorus, blood urea nitrogen (BUN), creatinine, sodium, potassium and blood hemoglobin were measured at the start of this study and after 4 months. Only Parathyroid hormone (PTH) was measured at the end of the study in both groups. Results: there was significant increase BSAP and significant reduction of phosphorus levels after 4 months with online HDF compared to high flux HD; p value 0.036 and <0.001 respectively. Conclusion:Online HDF has significant effect on bone markers and phosphorus clearance than high flux Hemodialysis but we need more prospective with longer durations studies to confirm this effects.

show abstract

Section: Discussioncontrasting

confidence: 70%

Effect of Dialysis Modality on Bone Disease in Patient with End Stage Renal Disease

Alwahab

Anwar

Elnasier

et al. 2021

The Egyptian Journal of Hospital Medicine

View full text Add to dashboard Cite

show abstract

“…Post hoc and pooled analyses suggest that a high convection volume may be needed to show better outcomes in online-HDF than in conventional HD 22 , 23 , 25 . European regulatory authorities have allowed online-HDF to be used in patients with uncontrolled hyperphosphatemia and those suffering from complications such as amyloidosis 21 , 42 , but this issue may not be similarly accepted in other countries because of limitations in setting up online-HDF. Before conducting online-HDF, new machines, quality control in substituting fluids, and trained staff are needed, all of which limit its utilization, particularly in primary clinics or developing countries 43 .…”

Section: Discussionmentioning

confidence: 99%

Cardiovascular Risk Comparison between Expanded Hemodialysis Using Theranova and Online Hemodiafiltration (CARTOON): A Multicenter Randomized Controlled Trial

Lee

Jang

Jeon

et al. 2021

Sci Rep

View full text Add to dashboard Cite

Expanded hemodialysis (HDx) with medium cutoff (MCO) membranes, which remove middle-to-large molecules well, may be a good option to replace online hemodiafiltration (online-HDF). To provide more evidence, this randomized controlled trial compared several cardiovascular parameters between patients undergoing HDx and online-HDF. Eighty patients undergoing thrice-weekly hemodialysis were randomly assigned to receive either HDx with a Theranova membrane (n = 43) or online-HDF (n = 37). The primary endpoints were changes in brachial-ankle pulse wave velocity (baPWV), echocardiographic parameters, and coronary artery calcium (CAC) scores over 1 year, and the secondary endpoints included blood cardiovascular biomarkers, mortality, and patient-reported outcomes. A linear mixed model and log-rank test were used to estimate the group differences. 65 patients had completed the trial. The changes in baPWV and echocardiographic parameters did not differ between the two groups. The CAC scores remained stable in the online-HDF group, whereas an increasing trend was shown in the HDx group (P = 0.012). Other endpoints, including cardiovascular and all-cause mortalities, were similar between the two groups. The changes in cardiovascular parameters did not differ between HDx with an MCO membrane and online-HDF. However, attention may be needed in patients with high CAC scores or scores with an increasing tendency when online-HDF is replaced with HDx with an MCO membrane.

show abstract

“…Albumin loss via HDF can differ depending on the dialyzer, dialysis modalities, and convection volumes. Previous studies have reported a wide range of albumin loss between 0.5 and 4.5 g per session in postdilution HDF [34][35][36]. The amount of albumin loss in mixed-HDF is not well known.…”

Section: Discussionmentioning

confidence: 99%

Mixed- versus predilution hemodiafiltration effects on convection volume and small and middle molecule clearance in hemodialysis patients: a prospective randomized controlled trial

Park

Kang

Chang

et al. 2021

Kidney Res Clin Pract

View full text Add to dashboard Cite

Background: The use of newly developed mixed-dilution hemodiafiltration (HDF) can supplement the weaknesses of pre-and postdilution HDF. However, it is unclear whether mixed-HDF performs well compared to predilution HDF. Methods: We conducted a prospective, open-labeled, randomized controlled trial from two hemodialysis centers in Korea. Between January 2017 and September 2019, 60 patients who underwent chronic hemodialysis were randomly assigned at a 1:1 ratio to receive either predilution HDF (n = 30) or mixed-HDF (n = 30) for 6 months. We compared convection volume, changes in small-and medium-sized molecule clearance, high-sensitive C-reactive protein (hs-CRP) level, and dialysis-related parameters between the two dialysis modalities. Results: A mean effective convection volume of 41.0 ± 10.3 L/session in the predilution HDF group and 51.5 ± 9.0 L/session in the mixed-HDF group was obtained by averaging values of three time-points. The difference in effective convection volume between the groups was 10.5 ± 1.3 L/session. This met the preset noninferiority criteria, suggesting that mixed-HDF was noninferior to predilution HDF. Moreover, the β2-microglobulin reduction rate was greater in the mixed-HDF group than in the predilution HDF group, while mixed-HDF provided greater transmembrane pressure. There were no significant between-group differences in Kt/V urea levels, changes in predialysis hs-CRP levels, proportions of overhydration, or blood pressure values. Symptomatic intradialytic hypotension episodes and other adverse events occurred similarly in the two groups. Conclusion: Use of mixed-HDF was comparable to predilution HDF in terms of delivered convection volume and clinical parameters. Moreover, mixed-HDF provided better β2-microglobulin clearance than predilution HDF.

show abstract

Effects of online hemodiafiltration on anemia and nutritional status in chronic hemodialysis patients

Cited by 11 publications

References 34 publications

Effect of Dialysis Modality on Bone Disease in Patient with End Stage Renal Disease

Effect of Dialysis Modality on Bone Disease in Patient with End Stage Renal Disease

Cardiovascular Risk Comparison between Expanded Hemodialysis Using Theranova and Online Hemodiafiltration (CARTOON): A Multicenter Randomized Controlled Trial

Mixed- versus predilution hemodiafiltration effects on convection volume and small and middle molecule clearance in hemodialysis patients: a prospective randomized controlled trial

Contact Info

Product

Resources

About