High-Target Hemodiafiltration Convective Dose Achieved in Most Patients in a 6-Month Intermediary Analysis of the CONVINCE Randomized Controlled Trial
(2023) In Kidney International Reports 8(11). p.2276-2283- Abstract
Introduction: High convection volumes in hemodiafiltration (HDF) result in improved survival; however, it remains unclear whether it is achievable in all patients. Methods: CONVINCE, a randomized controlled trial, randomized patients with end-stage kidney disease 1:1 to high-dose HDF versus high-flux hemodialysis (HD) continuation. We evaluated the proportion of patients achieving high-dose HDF target: convection volume per visit of ≥23 l (range ±1 l) at baseline, month 3, and month 6. We compared baseline characteristics in the following 2 ways: (i) patients on target for all 3 visits versus patients who missed target on ≥1 visits and (ii) patients on target for all 3 visits or missing it once versus patients who missed target on ≥2... (More)
Introduction: High convection volumes in hemodiafiltration (HDF) result in improved survival; however, it remains unclear whether it is achievable in all patients. Methods: CONVINCE, a randomized controlled trial, randomized patients with end-stage kidney disease 1:1 to high-dose HDF versus high-flux hemodialysis (HD) continuation. We evaluated the proportion of patients achieving high-dose HDF target: convection volume per visit of ≥23 l (range ±1 l) at baseline, month 3, and month 6. We compared baseline characteristics in the following 2 ways: (i) patients on target for all 3 visits versus patients who missed target on ≥1 visits and (ii) patients on target for all 3 visits or missing it once versus patients who missed target on ≥2 visits. Results: A total of 653 patients were randomized to HDF. Their mean age was 62.2 (SD 13.5) years, 36% were female, 81% had fistula vascular access, and 33% had diabetes. Across the 3 visits, 75 patients (11%), 27 patients (4%), and 11 patients (2%) missed the convection volume target once, twice, and thrice, respectively. Apart from diabetes, there were no apparent differences in patient characteristics between patients who always achieved the high-dose target (83%) and those who missed the target either once or more (17%) or twice or more (6%). Conclusion: Achieving high-dose HDF is feasible for nearly all patients in CONVINCE and could be maintained during the 6-month follow-up period. Apart from diabetes, there were no other indications for confounding by indication on multivariable analyses that may explain the potential survival advantage for patients receiving high-dose HDF.
(Less)
- author
- organization
- publishing date
- 2023-11
- type
- Contribution to journal
- publication status
- published
- subject
- keywords
- baseline characteristics, convection volume, hemodiafiltration, hemodialysis, kidney failure, randomized controlled trial
- in
- Kidney International Reports
- volume
- 8
- issue
- 11
- pages
- 8 pages
- publisher
- Elsevier
- external identifiers
-
- pmid:38025213
- scopus:85172020308
- ISSN
- 2468-0249
- DOI
- 10.1016/j.ekir.2023.08.004
- language
- English
- LU publication?
- yes
- id
- 1af7bc56-69d0-40ce-8230-5e548cd04751
- date added to LUP
- 2023-12-20 14:45:39
- date last changed
- 2024-04-19 00:17:21
@article{1af7bc56-69d0-40ce-8230-5e548cd04751,
abstract = {{<p>Introduction: High convection volumes in hemodiafiltration (HDF) result in improved survival; however, it remains unclear whether it is achievable in all patients. Methods: CONVINCE, a randomized controlled trial, randomized patients with end-stage kidney disease 1:1 to high-dose HDF versus high-flux hemodialysis (HD) continuation. We evaluated the proportion of patients achieving high-dose HDF target: convection volume per visit of ≥23 l (range ±1 l) at baseline, month 3, and month 6. We compared baseline characteristics in the following 2 ways: (i) patients on target for all 3 visits versus patients who missed target on ≥1 visits and (ii) patients on target for all 3 visits or missing it once versus patients who missed target on ≥2 visits. Results: A total of 653 patients were randomized to HDF. Their mean age was 62.2 (SD 13.5) years, 36% were female, 81% had fistula vascular access, and 33% had diabetes. Across the 3 visits, 75 patients (11%), 27 patients (4%), and 11 patients (2%) missed the convection volume target once, twice, and thrice, respectively. Apart from diabetes, there were no apparent differences in patient characteristics between patients who always achieved the high-dose target (83%) and those who missed the target either once or more (17%) or twice or more (6%). Conclusion: Achieving high-dose HDF is feasible for nearly all patients in CONVINCE and could be maintained during the 6-month follow-up period. Apart from diabetes, there were no other indications for confounding by indication on multivariable analyses that may explain the potential survival advantage for patients receiving high-dose HDF.</p>}},
author = {{Vernooij, Robin W.M. and Hockham, C. and Barth, C. and Canaud, B. and Cromm, K. and Davenport, A. and Hegbrant, J. and Rose, M. and Strippoli, G. F.M. and Török, M. and Woodward, M. and Bots, M. L. and Blankestijn, P. J.}},
issn = {{2468-0249}},
keywords = {{baseline characteristics; convection volume; hemodiafiltration; hemodialysis; kidney failure; randomized controlled trial}},
language = {{eng}},
number = {{11}},
pages = {{2276--2283}},
publisher = {{Elsevier}},
series = {{Kidney International Reports}},
title = {{High-Target Hemodiafiltration Convective Dose Achieved in Most Patients in a 6-Month Intermediary Analysis of the CONVINCE Randomized Controlled Trial}},
url = {{http://dx.doi.org/10.1016/j.ekir.2023.08.004}},
doi = {{10.1016/j.ekir.2023.08.004}},
volume = {{8}},
year = {{2023}},
}