Shroff, Rukshana, Smith, Colette ORCID: 0000-0003-2847-3355, Ranchin, Bruno, Bayazit, Aysun K., Stefanidis, Constantinos J., Askiti, Varvara, Azukaitis, Karolis, Canpolat, Nur ORCID: 0000-0002-3420-9756, Agbas, Ayse ORCID: 0000-0002-3658-8622, Aitkenhead, Helen, Anarat, Ali, Aoun, Bilal, Aofolaju, Daley, Bakkaloglu, Sevcan Azime, Bhowruth, Devina, Borzych-Duzalka, Dagmara, Bulut, Ipek Kaplan, Buescher, Rainer, Deanfield, John ORCID: 0000-0001-8806-6052, Dempster, Claire, Duzova, Ali, Habbig, Sandra, Hayes, Wesley, Hegde, Shivram, Krid, Saoussen, Licht, Christoph, Litwin, Mieczyslaw ORCID: 0000-0002-5241-2483, Mayes, Mark, Mir, Sevgi, Nemec, Rose, Obrycki, Lukasz ORCID: 0000-0002-5134-8643, Paglialonga, Fabio, Picca, Stefano, Samaille, Charlotte, Shenoy, Mohan, Sinha, Manish D., Spasojevic, Brankica, Stronach, Lynsey, Vidal, Enrico, Vondrak, Karel, Yilmaz, Alev, Zaloszyc, Ariane, Fischbach, Michel, Schmitt, Claus Peter and Schaefer, Franz (2019). Effects of Hemodiafiltration versus Conventional Hemodialysis in Children with ESKD: The HDF, Heart and Height Study. J. Am. Soc. Nephrol., 30 (4). S. 678 - 692. WASHINGTON: AMER SOC NEPHROLOGY. ISSN 1533-3450

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Abstract

Background 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.

Item Type: Journal Article
Creators:
CreatorsEmailORCIDORCID Put Code
Shroff, RukshanaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Smith, ColetteUNSPECIFIEDorcid.org/0000-0003-2847-3355UNSPECIFIED
Ranchin, BrunoUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Bayazit, Aysun K.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Stefanidis, Constantinos J.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Askiti, VarvaraUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Azukaitis, KarolisUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Canpolat, NurUNSPECIFIEDorcid.org/0000-0002-3420-9756UNSPECIFIED
Agbas, AyseUNSPECIFIEDorcid.org/0000-0002-3658-8622UNSPECIFIED
Aitkenhead, HelenUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Anarat, AliUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Aoun, BilalUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Aofolaju, DaleyUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Bakkaloglu, Sevcan AzimeUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Bhowruth, DevinaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Borzych-Duzalka, DagmaraUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Bulut, Ipek KaplanUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Buescher, RainerUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Deanfield, JohnUNSPECIFIEDorcid.org/0000-0001-8806-6052UNSPECIFIED
Dempster, ClaireUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Duzova, AliUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Habbig, SandraUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Hayes, WesleyUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Hegde, ShivramUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Krid, SaoussenUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Licht, ChristophUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Litwin, MieczyslawUNSPECIFIEDorcid.org/0000-0002-5241-2483UNSPECIFIED
Mayes, MarkUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Mir, SevgiUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Nemec, RoseUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Obrycki, LukaszUNSPECIFIEDorcid.org/0000-0002-5134-8643UNSPECIFIED
Paglialonga, FabioUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Picca, StefanoUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Samaille, CharlotteUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Shenoy, MohanUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Sinha, Manish D.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Spasojevic, BrankicaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Stronach, LynseyUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Vidal, EnricoUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Vondrak, KarelUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Yilmaz, AlevUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Zaloszyc, ArianeUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Fischbach, MichelUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Schmitt, Claus PeterUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Schaefer, FranzUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
URN: urn:nbn:de:hbz:38-152030
DOI: 10.1681/ASN.2018100990
Journal or Publication Title: J. Am. Soc. Nephrol.
Volume: 30
Number: 4
Page Range: S. 678 - 692
Date: 2019
Publisher: AMER SOC NEPHROLOGY
Place of Publication: WASHINGTON
ISSN: 1533-3450
Language: English
Faculty: Unspecified
Divisions: Unspecified
Subjects: no entry
Uncontrolled Keywords:
KeywordsLanguage
INTIMA-MEDIA THICKNESS; POST-DILUTION HEMODIAFILTRATION; HIGH-FLUX HEMODIALYSIS; STAGE RENAL-DISEASE; ALL-CAUSE MORTALITY; QUALITY-OF-LIFE; ONLINE HEMODIAFILTRATION; RECOVERY-TIME; VASCULAR CALCIFICATION; CARDIOVASCULAR EVENTSMultiple languages
Urology & NephrologyMultiple languages
Refereed: Yes
URI: http://kups.ub.uni-koeln.de/id/eprint/15203

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