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Treatment tolerance and patient-reported outcomes favor online hemodiafiltration compared to high-flux hemodialysis in the elderly
- Source :
- Kidney International, Kidney International, Nature Publishing Group, 2017, 91 (6), pp.1495-1509. ⟨10.1016/j.kint.2017.01.013⟩, Kidney International, 2017, 91 (6), pp.1495-1509. ⟨10.1016/j.kint.2017.01.013⟩
- Publication Year :
- 2017
- Publisher :
- HAL CCSD, 2017.
-
Abstract
- Large cohort studies suggest that high convective volumes associated with online hemodiafiltration may reduce the risk of mortality/morbidity compared to optimal high-flux hemodialysis. By contrast, intradialytic tolerance is not well studied. The aim of the FRENCHIE (French Convective versus Hemodialysis in Elderly) study was to compare high-flux hemodialysis and online hemodiafiltration in terms of intradialytic tolerance. In this prospective, open-label randomized controlled trial, 381 elderly chronic hemodialysis patients (over age 65) were randomly assigned in a one-to-one ratio to either high-flux hemodialysis or online hemodiafiltration. The primary outcome was intradialytic tolerance (day 30-day 120). Secondary outcomes included health-related quality of life, cardiovascular risk biomarkers, morbidity, and mortality. During the observational period for intradialytic tolerance, 85% and 84% of patients in high-flux hemodialysis and online hemodiafiltration arms, respectively, experienced at least one adverse event without significant difference between groups. As exploratory analysis, intradialytic tolerance was also studied, considering the sessions as a statistical unit according to treatment actually received. Over a total of 11,981 sessions, 2,935 were complicated by the occurrence of at least one adverse event, with a significantly lower occurrence in online hemodiafiltration with fewer episodes of intradialytic symptomatic hypotension and muscle cramps. By contrast, health-related quality of life, morbidity, and mortality were not different in both groups. An improvement in the control of metabolic bone disease biomarkers and β2-microglobulin level without change in serum albumin concentration was observed with online hemodiafiltration. Thus, overall outcomes favor online hemodiafiltration over high-flux hemodialysis in the elderly.
- Subjects :
- Male
Time Factors
medicine.medical_treatment
030232 urology & nephrology
Kaplan-Meier Estimate
030204 cardiovascular system & hematology
Kidney
[SDV.MHEP.UN]Life Sciences [q-bio]/Human health and pathology/Urology and Nephrology
law.invention
0302 clinical medicine
Randomized controlled trial
Quality of life
law
Risk of mortality
Prospective Studies
Prospective cohort study
ComputingMilieux_MISCELLANEOUS
Aged, 80 and over
Age Factors
3. Good health
Hospitalization
Treatment Outcome
Nephrology
Female
Kidney Diseases
France
Hemodialysis
medicine.symptom
safety
medicine.medical_specialty
Metabolic bone disease
03 medical and health sciences
Renal Dialysis
Internal medicine
medicine
Humans
Intensive care medicine
Adverse effect
Geriatric Assessment
Aged
hemodiafiltration
intradialytic tolerance
business.industry
medicine.disease
[SDV.MHEP.UN] Life Sciences [q-bio]/Human health and pathology/Urology and Nephrology
mortality
cardiovascular risk biomarkers
[SDV.SPEE] Life Sciences [q-bio]/Santé publique et épidémiologie
Quality of Life
[SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie
business
chronic kidney disease
Muscle cramp
Subjects
Details
- Language :
- English
- ISSN :
- 00852538 and 15231755
- Database :
- OpenAIRE
- Journal :
- Kidney International, Kidney International, Nature Publishing Group, 2017, 91 (6), pp.1495-1509. ⟨10.1016/j.kint.2017.01.013⟩, Kidney International, 2017, 91 (6), pp.1495-1509. ⟨10.1016/j.kint.2017.01.013⟩
- Accession number :
- edsair.doi.dedup.....ef45efe3eb7310e744358f7d1920896d