De Zan, Francesca, Smith, Colette ORCID: 0000-0003-2847-3355, Duzova, Ali, Bayazit, Aysun, Stefanidis, Constantinos J. ORCID: 0000-0002-6342-4877, Askiti, Varvara, Azukaitis, Karolis ORCID: 0000-0001-7953-1338, Canpolat, Nur ORCID: 0000-0002-3420-9756, Agbas, Ayse, Anarat, Ali, Aoun, Bilal, Bakkaloglu, Sevcan A., Borzych-Duzalka, Dagmara, Bulut, Ipek Kaplan, Habbig, Sandra, Krid, Saoussen, Licht, Christoph, Litwin, Mieczyslaw, Obrycki, Lukasz, Paglialonga, Fabio, Ranchin, Bruno, Samaille, Charlotte, Shenoy, Mohan, Sinha, Manish D., Spasojevic, Brankica, Yilmaz, Alev, Fischbach, Michel, Schmitt, Claus Peter, Schaefer, Franz, Vidal, Enrico ORCID: 0000-0003-3963-0803 and Shroff, Rukshana ORCID: 0000-0001-8501-1072 (2021). Hemodiafiltration maintains a sustained improvement in blood pressure compared to conventional hemodialysis in children-the HDF, heart and height (3H) study. Pediatr. Nephrol., 36 (8). S. 2393 - 2404. NEW YORK: SPRINGER. ISSN 1432-198X

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Abstract

Background Hypertension is prevalent in children on dialysis and associated with cardiovascular disease. We studied the blood pressure (BP) trends and the evolution of BP over 1 year in children on conventional hemodialysis (HD) vs. hemodiafiltration (HDF). Methods This is a post hoc analysis of the 3H - HDF-Hearts-Height dataset, a multicenter, parallel-arm observational study. Seventy-eight children on HD and 55 on HDF who had three 24-h ambulatory BP monitoring (ABPM) measures over 1 year were included. Mean arterial pressure (MAP) was calculated and hypertension defined as 24-h MAP standard deviation score (SDS) >= 95th percentile. Results Poor agreement between pre-dialysis systolic BP-SDS and 24-h MAP was found (mean difference - 0.6; 95% limits of agreement -4.9-3.8). At baseline, 82% on HD and 44% on HDF were hypertensive, with uncontrolled hypertension in 88% vs. 25% respectively; p < 0.001. At 12 months, children on HDF had consistently lower MAP-SDS compared to those on HD (p < 0.001). Over 1-year follow-up, the HD group had mean MAP-SDS increase of +0.98 (95%CI 0.77-1.20; p < 0.0001), whereas the HDF group had a non-significant increase of +0.15 (95%CI -0.10-0.40; p = 0.23). Significant predictors of MAP-SDS were dialysis modality (beta = +0.83 [95%CI +0.51 - +1.15] HD vs. HDF, p < 0.0001) and higher inter-dialytic-weight-gain (IDWG)% (beta = 0.13 [95%CI 0.06-0.19]; p = 0.0003). Conclusions Children on HD had a significant and sustained increase in BP over 1 year compared to a stable BP in those on HDF, despite an equivalent dialysis dose. Higher IDWG% was associated with higher 24-h MAP-SDS in both groups.

Item Type: Journal Article
Creators:
CreatorsEmailORCIDORCID Put Code
De Zan, FrancescaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Smith, ColetteUNSPECIFIEDorcid.org/0000-0003-2847-3355UNSPECIFIED
Duzova, AliUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Bayazit, AysunUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Stefanidis, Constantinos J.UNSPECIFIEDorcid.org/0000-0002-6342-4877UNSPECIFIED
Askiti, VarvaraUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Azukaitis, KarolisUNSPECIFIEDorcid.org/0000-0001-7953-1338UNSPECIFIED
Canpolat, NurUNSPECIFIEDorcid.org/0000-0002-3420-9756UNSPECIFIED
Agbas, AyseUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Anarat, AliUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Aoun, BilalUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Bakkaloglu, Sevcan A.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Borzych-Duzalka, DagmaraUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Bulut, Ipek KaplanUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Habbig, SandraUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Krid, SaoussenUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Licht, ChristophUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Litwin, MieczyslawUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Obrycki, LukaszUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Paglialonga, FabioUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Ranchin, BrunoUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Samaille, CharlotteUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Shenoy, MohanUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Sinha, Manish D.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Spasojevic, BrankicaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Yilmaz, AlevUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Fischbach, MichelUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Schmitt, Claus PeterUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Schaefer, FranzUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Vidal, EnricoUNSPECIFIEDorcid.org/0000-0003-3963-0803UNSPECIFIED
Shroff, RukshanaUNSPECIFIEDorcid.org/0000-0001-8501-1072UNSPECIFIED
URN: urn:nbn:de:hbz:38-606620
DOI: 10.1007/s00467-021-04930-2
Journal or Publication Title: Pediatr. Nephrol.
Volume: 36
Number: 8
Page Range: S. 2393 - 2404
Date: 2021
Publisher: SPRINGER
Place of Publication: NEW YORK
ISSN: 1432-198X
Language: English
Faculty: Unspecified
Divisions: Unspecified
Subjects: no entry
Uncontrolled Keywords:
KeywordsLanguage
Pediatrics; Urology & NephrologyMultiple languages
URI: http://kups.ub.uni-koeln.de/id/eprint/60662

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