Biomedical Science Letters (대한의생명과학회지)

The Korean Society for Biomedical Laboratory Sciences (대한의생명과학회)
권호 표지
DOI QR코드

DOI QR Code

Seven-year Survival Rate of On-line Hemodiafiltration

  • Yoon, Jung-Hwan (Department of Internal Medicine, Chonnam National University Hospital) ;
  • Kim, Nam-Ho (Department of Internal Medicine, Chonnam National University Hospital)
  • Received : 2018.12.11
  • Accepted : 2019.02.12
  • Published : 2019.03.31
Download PDF
⟨ Previous Next ⟩

Abstract

Conventional high-flux hemodialysis (HD) is not as good as normal kidney function. Morbidity and mortality rates of patients receiving HD are still very high. To increase mid-to-large molecule clearance by combining diffusion and convection, on-line hemodiafiltration (HDF) is required. The objective of this study was to compare long-term survival rate of patients treated with on-line HDF to those who received conventional high-flux HD by reviewing data from Chonnam National University Hospital (CNUH). We selected patients who attended the 'CUNH dialysis center' and agreed to participate in the study. Overall, 40 patients with ESRD switched from high flux HD to on-line HDF or started on-line HDF from August 2007 to December 2009. Additionally, a total of 42 patients receiving conventional high-flux HD during the same period were enrolled. We then reviewed long-term survival rate of patients receiving on-line HDF over the next seven years. When we compared survival rates for seven years, the survival rate of the group receiving on-line HDF was 65% (26/40) while that of the group receiving the conventional high-flux HD was 54.8% (23/42). Although the number of patients was small to see survival difference clearly by one specific dialysis modality, there was somewhat difference in survival rate between the two groups. Indicators such as anemia, calcium-phosphate metabolism, nutritional status, treatment adequacy, and hospitalization were also improved in the group receiving HDF. Overall, results of our study showed beneficial effects of on-line HDF on clinical outcomes and survival in chronic HD patients.

Keywords

References

  1. Akizawa T, Koiwa F. Clinical Expectation of Online Hemodiafiltration: A Japanese Perspective. Blood Purif. 2015. 40: 12-16. https://doi.org/10.1159/000437405
  2. Albalate Ramon M, de Sequera Ortiz P, Perez-Garcia R, Corchete Prats E, Alcazar Arroyo R, Ortega Diaz M, Puerta Carretero M. What is the optimum dialysate flow in post-dilution online haemodiafiltration? Neflologia. 2015. 35: 533-538.
  3. Canaud B, Morena M, Leray-Moragues H, Chalabi L, Cristol JP. Overview of clinical studies in hemodiafiltration: what do we need now? Hemodial Int. 2006. 10: S5-S12.
  4. Davenport A, Peters SA, Bots ML, Canaud B, Grooteman MP, Asci G, Locatelli F, Maduell F, Morena M, Nube MJ, Ok E, Torres F, Woodward M, Blankestijn PJ; HDF Pooling Project Investigators. Higher convection volume exchange with online hemodiafiltration is associated with survival advantage for dialysis patients: the effect of adjustment for body size. Kidney Int. 2016. 89: 193-199. https://doi.org/10.1038/ki.2015.264
  5. Grooteman MP, van den Dorpel MA, Bots ML, Penne EL, van der Weerd NC, Mazairac AH, den Hoedt CH, van der Tweel I, Levesque R, Nube MJ, ter Wee PM, Blankestijn PJ; CONTRAST Investigators. Effect of Online Hemodiafiltration on All-Cause Mortality and Cardiovascular Outcomes. J Am Soc Nephrol. 2012. 23: 1087-1096. https://doi.org/10.1681/ASN.2011121140
  6. Jean G, Hurot JM, Deleaval P, Mayor B, Lorriaux C. Onlinehaemodiafiltration vs. conventional haemodialysis: a crossover study. BMC Nephrol. 2015. 16: 70. https://doi.org/10.1186/s12882-015-0062-0
  7. Jones JP, Leonard EF, Sandhu G, Winkel G, Levin NW, Cortell S. Daily ultrafiltration results in improved blood pressure control and more efficient removal of small molecules during hemodialysis. Blood Purif. 2012. 34: 325-331. https://doi.org/10.1159/000345334
  8. Locatelli F, Canaud B. Dialysis adequacy today: a European perspective. Nephrol Dial Transplant. 2012. 27: 3043-3048. https://doi.org/10.1093/ndt/gfs184
  9. Locatelli F, Violo L, Longhi S, Del Vecchio L. Current Evidence in Haemodiafiltration. Blood Purif. 2015. 40: 24-29. https://doi.org/10.1159/000437410
  10. Maduell F. Is There an 'Optimal Dose' of Hemodiafiltration? Blood Purif. 2015. 40: 17-23. https://doi.org/10.1159/000437409
  11. Maduell F, Moreso F, Pons M, Ramos R, Mora-Macia J, Foraster A, Soler J, Galceran JM, Martinez-Castelao A. Online Hemodiafiltration Study Group from the Catalonian Society of Nephrology. J Nephrol. 2011. 24: 196-202. https://doi.org/10.5301/JN.2010.386
  12. Mazairac AH, Blankestijn PJ, Grooteman MP, Penne EL, van der Weerd NC, den Hoedt CH, Buskens E, van den Dorpel MA, ter Wee PM, Nube MJ, Bots ML, de Wit GA; CONTRAST investigators. The cost-utility of haemodiafiltration versus haemodialysis in the Convective Transport Study. Nephol Dial Transplant. 2013. 28: 1865-1873. https://doi.org/10.1093/ndt/gft045
  13. Mostovaya IM, Grooteman MP, Basile C, Davenport A, de Roij van Zuijdewijn CL, Wanner C, Nube MJ, Blankestijn PJ. High convection volume in online post-dilution haemodiafiltration: relevance, safety and costs. Clin Kidney J. 2015. 8: 368-373. https://doi.org/10.1093/ckj/sfv040
  14. Moura A, Madureira J, Alija P, Fernandes JC, Oliveira JG, Lopez M, Filgueiras M, Amado L, Sameiro-Faria M, Miranda V, Santos-Silva A, Costa E. Effect of Aging in the Perception of Health-Related Quality of Life in End-Stage Renal Disease Patients under Online-Hemodiafiltration. Aging Dis. 2014. 6: 17-626. https://doi.org/10.14336/AD.2014.0514
  15. Potier J, Le Roy F, Faucon JP, Besselievre T, Renaudineau E, Farquet C, Soihan P, Touzard D, Djema A, Ilinca T. Elevated removal of middle molecules without significant albumin loss with mixed-dilution hemodiafiltration for patients unable to provide sufficient blood flow rates. Blood Purif. 2013. 36: 78-83. https://doi.org/10.1159/000351527
  16. Schmid H, Schiffl H. Hemodiafiltration and survival of end-stage renal disease patients: the long journey goes on. Int Urology Nephrol. 2012. 44: 1435-1440. https://doi.org/10.1007/s11255-012-0232-y
  17. Smirnov AV, Nesterova OB, Suglobova ED, Golubev RV, Vasil'ev AN, Vasil'eva IA, Verbitskaia EV, Korosteleva NIu, Kostereva EM, Lebedeva EB, Levykina EN, Starosel'skii KG, Lazeba VA. Clinical and laboratory evaluation of the efficiency of chronic hemodialysis treatment using acidosuccinate in patients with terminal renal failure. Ter Arkh. 2013. 85: 69-75.
  18. Tiranathanagul K, Susantitaphong P, Towannang P, Injan P, Praditpornsilpa K, Eiam-Ong S. Measurement of vascular access flow by online clearance monitor in online hemodiafiltration. Blood Purif. 2011. 32: 195-201. https://doi.org/10.1159/000327608
  19. Van Laecke S, De Wilde K, Vanholder R. Online hemodiafiltration. Artif Organs. 2006. 30: 579-585. https://doi.org/10.1111/j.1525-1594.2006.00266.x
  20. Vilar E, Fry AC, Wellsted D, Tattersall JE, Greenwood RN, Farrington K. Long-Term Outcomes in Online Hemodiafiltration and High-Flux Hemodialysis: A Comparative Analysis. Clin J Am Soc Nephrol. 2009. 4: 1944-1953. https://doi.org/10.2215/CJN.05560809
  21. Wizemann V, Lotz C, Techert F, Uthoff S. On-line haemodiafiltration versus low-flux haemodialysis. A prospective randomized study. Nephol Dial Transplant. 2000. 15: 43-48. https://doi.org/10.1093/oxfordjournals.ndt.a027963