Higher convection volume exchange with online hemodiafiltration is associated with survival advantage for dialysis patients: the effect of adjustment for body size

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dc.contributor.authorDavenport, Andrew
dc.contributor.authorPeters, Sanne A. E.
dc.contributor.authorBots, Michiel L.
dc.contributor.authorCanaud, Bernard
dc.contributor.authorGrooteman, Muriel P. C.
dc.contributor.authorAsci, Gulay
dc.contributor.authorLocatelli, Francesco
dc.contributor.authorMaduell, Francisco
dc.contributor.authorMorena, Marion
dc.contributor.authorNube, Menso J.
dc.contributor.authorOk, Ercan
dc.contributor.authorTorres, Ferran
dc.contributor.authorWoodward, Mark
dc.contributor.authorBlankestijn, Peter J.
dc.date.accessioned2019-10-27T22:58:41Z
dc.date.available2019-10-27T22:58:41Z
dc.date.issued2016
dc.departmentEge Üniversitesien_US
dc.description.abstractMortality remains high for hemodialysis patients. Online hemodiafiltration (OL-HDF) removes more middle-sized uremic toxins but outcomes of individual trials comparing OL-HDF with hemodialysis have been discrepant. Secondary analyses reported higher convective volumes, easier to achieve in larger patients, and improved survival. Here we tested different methods to standardize OL-HDF convection volume on all-cause and cardiovascular mortality compared with hemodialysis. Pooled individual patient analysis of four prospective trials compared thirds of delivered convection volume with hemodialysis. Convection volumes were either not standardized or standardized to weight, body mass index, body surface area, and total body water. Data were analyzed by multivariable Cox proportional hazards modeling from 2793 patients. All-cause mortality was reduced when the convective dose was unstandardized or standardized to body surface area and total body water; hazard ratio (95% confidence intervals) of 0.65 (0.51-0.82), 0.74 (0.58-0.93), and 0.71 (0.56-0.93) for those receiving higher convective doses. Standardization by body weight or body mass index gave no significant survival advantage. Higher convection volumes were generally associated with greater survival benefit with OL-HDF, but results varied across different ways of standardization for body size. Thus, further studies should take body size into account when evaluating the impact of delivered convection volume on mortality end points.en_US
dc.description.sponsorshipEuDial, the dialysis subcommittee of the European Renal Association - European Dialysis & Transplant Associationen_US
dc.description.sponsorshipThe pooling project was funded by EuDial, the dialysis subcommittee of the European Renal Association - European Dialysis & Transplant Association.en_US
dc.identifier.doi10.1038/ki.2015.264en_US
dc.identifier.endpage199en_US
dc.identifier.issn0085-2538
dc.identifier.issn1523-1755
dc.identifier.issue1en_US
dc.identifier.pmid26352299en_US
dc.identifier.scopusqualityQ1en_US
dc.identifier.startpage193en_US
dc.identifier.urihttps://doi.org/10.1038/ki.2015.264
dc.identifier.urihttps://hdl.handle.net/11454/51617
dc.identifier.volume89en_US
dc.identifier.wosWOS:000368321300028en_US
dc.identifier.wosqualityQ1en_US
dc.indekslendigikaynakWeb of Scienceen_US
dc.indekslendigikaynakScopusen_US
dc.indekslendigikaynakPubMeden_US
dc.language.isoenen_US
dc.publisherElsevier Science Incen_US
dc.relation.ispartofKidney Internationalen_US
dc.relation.publicationcategoryMakale - Uluslararası Hakemli Dergi - Kurum Öğretim Elemanıen_US
dc.rightsinfo:eu-repo/semantics/closedAccessen_US
dc.subjectbody compositionen_US
dc.subjectbody mass indexen_US
dc.subjectbody surface areaen_US
dc.subjecthemodiafiltrationen_US
dc.subjectKt/Ven_US
dc.subjecttotal body wateren_US
dc.titleHigher convection volume exchange with online hemodiafiltration is associated with survival advantage for dialysis patients: the effect of adjustment for body sizeen_US
dc.typeArticleen_US

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