Effects of Hemodiafiltration versus Conventional Hemodialysis in Children with ESKD: The HDF, Heart and Height Study

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dc.contributor.authorShroff, Rukshana
dc.contributor.authorSmith, Colette
dc.contributor.authorRanchin, Bruno
dc.contributor.authorBayazit, Aysun K.
dc.contributor.authorStefanidis, Constantinos J.
dc.contributor.authorAskiti, Varvara
dc.contributor.authorAzukaitis, Karolis
dc.contributor.authorCanpolat, Nur
dc.contributor.authorAgbas, Ayse
dc.contributor.authorAitkenhead, Helen
dc.contributor.authorAnarat, Ali
dc.contributor.authorAoun, Bilal
dc.contributor.authorAofolaju, Daley
dc.contributor.authorBakkaloglu, Sevcan Azime
dc.contributor.authorBhowruth, Devina
dc.contributor.authorBorzych-Duzalka, Dagmara
dc.contributor.authorBulut, Ipek Kaplan
dc.contributor.authorBuescher, Rainer
dc.contributor.authorDeanfield, John
dc.contributor.authorDempster, Claire
dc.contributor.authorDuzova, Ali
dc.contributor.authorHabbig, Sandra
dc.contributor.authorHayes, Wesley
dc.contributor.authorHegde, Shivram
dc.contributor.authorKrid, Saoussen
dc.contributor.authorLicht, Christoph
dc.contributor.authorLitwin, Mieczyslaw
dc.contributor.authorMayes, Mark
dc.contributor.authorMir, Sevgi
dc.contributor.authorNemec, Rose
dc.contributor.authorObrycki, Lukasz
dc.contributor.authorPaglialonga, Fabio
dc.contributor.authorPicca, Stefano
dc.contributor.authorSamaille, Charlotte
dc.contributor.authorShenoy, Mohan
dc.contributor.authorSinha, Manish D.
dc.contributor.authorSpasojevic, Brankica
dc.contributor.authorStronach, Lynsey
dc.contributor.authorVidal, Enrico
dc.contributor.authorVondrak, Karel
dc.contributor.authorYilmaz, Alev
dc.contributor.authorZaloszyc, Ariane
dc.contributor.authorFischbach, Michel
dc.contributor.authorSchmitt, Claus Peter
dc.contributor.authorSchaefer, Franz
dc.date.accessioned2019-10-27T09:45:09Z
dc.date.available2019-10-27T09:45:09Z
dc.date.issued2019
dc.departmentEge Üniversitesien_US
dc.description.abstractBackground Hypertension and cardiovascular disease are common in children undergoing dialysis. Studies suggest that hemodiafiltration (HDF) may reduce cardiovascular mortality in adults, but data for children are scarce. Methods The HDF, Heart and Height study is a nonrandomized observational study comparing outcomes on conventional hemodialysis (HD) versus postdilution online HDF in children. Primary outcome measures were annualized changes in carotid intima-media thickness (cIMT) SD score and height SD score. Results We enrolled 190 children from 28 centers; 78 on HD and 55 on HDF completed 1-year follow-up. The groups were comparable for age, dialysis vintage, access type, dialysis frequency, blood flow, and residual renal function. At 1 year, cIMT SD score increased significantly in children on HD but remained static in the HDF cohort. On propensity score analysis, HD was associated with a +0.47 higher annualized cIMT SD score compared with HDF. Height SD score increased in HDF but remained static in HD. Mean arterial pressure SD score increased with HD only. Factors associated with higher cIMT and mean arterial pressure SD-scores were HD group, higher ultrafiltration rate, and higher 2-microglobulin. The HDF cohort had lower 2-microglobulin, parathyroid hormone, and high-sensitivity C-reactive protein at 1 year; fewer headaches, dizziness, or cramps; and shorter postdialysis recovery time. Conclusions HDF is associated with a lack of progression in vascular measures versus progression with HD, as well as an increase in height not seen in the HD cohort. Patient-related outcomes improved among children on HDF correlating with improved BP control and clearances. Confirmation through randomized trials is required.en_US
dc.description.sponsorshipNational Institute for Health ResearchNational Institute for Health Research (NIHR); Kidney Research UKKidney Research UK (KRUK); Fresenius Medical Careen_US
dc.description.sponsorshipR.S. holds a Career Development Fellowship with the National Institute for Health Research. The 3H study was sponsored by Kidney Research UK. Part sponsorship was obtained from Fresenius Medical Care.en_US
dc.identifier.doi10.1681/ASN.2018100990
dc.identifier.endpage691en_US
dc.identifier.issn1046-6673
dc.identifier.issn1533-3450
dc.identifier.issn1046-6673en_US
dc.identifier.issn1533-3450en_US
dc.identifier.issue4en_US
dc.identifier.scopusqualityQ1en_US
dc.identifier.startpage678en_US
dc.identifier.urihttps://doi.org/10.1681/ASN.2018100990
dc.identifier.urihttps://hdl.handle.net/11454/29103
dc.identifier.volume30en_US
dc.identifier.wosWOS:000463913200016en_US
dc.identifier.wosqualityQ1en_US
dc.indekslendigikaynakWeb of Scienceen_US
dc.indekslendigikaynakScopusen_US
dc.language.isoenen_US
dc.publisherAmer Soc Nephrologyen_US
dc.relation.ispartofJournal of the American Society of Nephrologyen_US
dc.relation.publicationcategoryMakale - Uluslararası Hakemli Dergi - Kurum Öğretim Elemanıen_US
dc.rightsinfo:eu-repo/semantics/openAccessen_US
dc.subjecthemodialysisen_US
dc.subjecthemodiafiltration (HDF)en_US
dc.subjectcarotid intima-media thicknessen_US
dc.subjectgrowthen_US
dc.subjectcardiovascular diseaseen_US
dc.subjectchildrenen_US
dc.titleEffects of Hemodiafiltration versus Conventional Hemodialysis in Children with ESKD: The HDF, Heart and Height Studyen_US
dc.typeArticleen_US

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