eprintid: 10053138
rev_number: 25
eprint_status: archive
userid: 608
dir: disk0/10/05/31/38
datestamp: 2018-11-14 13:44:29
lastmod: 2021-10-17 23:50:54
status_changed: 2018-11-14 13:44:29
type: article
metadata_visibility: show
creators_name: Davenport, A
creators_name: Peters, SAE
creators_name: Bots, ML
creators_name: Canaud, B
creators_name: Grooteman, MPC
creators_name: Asci, G
creators_name: Locatelli, F
creators_name: Maduell, F
creators_name: Morena, M
creators_name: Nube, MJ
creators_name: Ok, E
creators_name: Torres, F
creators_name: Woodward, M
creators_name: Blankestijn, PJ
title: Higher convection volume exchange with online hemodiafiltration is associated with survival advantage for dialysis patients: the effect of adjustment for body size
ispublished: pub
divisions: UCL
divisions: B02
divisions: C10
divisions: D17
keywords: body composition, body mass index, body surface area, hemodiafiltration, Kt/V, total body water
note: This version is the author accepted manuscript. For information on re-use, please refer to the publisher’s terms and conditions.
abstract: Mortality 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.
date: 2016-01
date_type: published
publisher: NATURE PUBLISHING GROUP
official_url: https://doi.org/10.1038/ki.2015.264
oa_status: green
full_text_type: other
language: eng
primo: open
primo_central: open_green
verified: verified_manual
elements_id: 1057477
doi: 10.1038/ki.2015.264
lyricists_name: Davenport, Andrew
lyricists_id: ADAVE78
actors_name: Jayawardana, Anusha
actors_id: AJAYA51
actors_role: owner
full_text_status: public
publication: Kidney International
volume: 89
number: 1
pagerange: 193-199
pages: 7
issn: 1523-1755
citation:        Davenport, A;    Peters, SAE;    Bots, ML;    Canaud, B;    Grooteman, MPC;    Asci, G;    Locatelli, F;                             ... Blankestijn, PJ; + view all <#>        Davenport, A;  Peters, SAE;  Bots, ML;  Canaud, B;  Grooteman, MPC;  Asci, G;  Locatelli, F;  Maduell, F;  Morena, M;  Nube, MJ;  Ok, E;  Torres, F;  Woodward, M;  Blankestijn, PJ;   - view fewer <#>    (2016)    Higher convection volume exchange with online hemodiafiltration is associated with survival advantage for dialysis patients: the effect of adjustment for body size.                   Kidney International , 89  (1)   pp. 193-199.    10.1038/ki.2015.264 <https://doi.org/10.1038/ki.2015.264>.       Green open access   
 
document_url: https://discovery.ucl.ac.uk/id/eprint/10053138/1/Davenport_HDFvolumepaper.pdf