A Randomized Trial of Hemodiafiltration and Change in Cardiovascular Parameters

Mostovaya, Ira M.; Bots, Michiel L.; Dorpel, Marinus A. van den; Grooteman, Muriël P.C.; Kamp, Otto; Lévesque, Renée; Wee, Piet M. ter; Nubé, Menso J.

doi:10.2215/cjn.07140713

Cited by 36 publications

(43 citation statements)

References 28 publications

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“…Although another study observed no differences in carotid-femoral PWV between haemodialysis and haemodiafiltration groups [22], this negative study of just over 100 patients employed multiple observers making a limited number of measurements in a younger dialysis population with fewer diabetics with no correction for heart rate. PWV is affected by peripheral blood pressure, vascular resistance and cardiac output, in keeping with these earlier studies.…”

Section: Discussionmentioning

confidence: 99%

Treatment with Haemodiafiltration Stabilises Vascular Stiffness (Measured by Aortic Pulse Wave Velocity) Compared to Haemodialysis

Charitaki

Belman

Davenport³

2014

Nephron Clin Pract

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Background/Aims: Cerebrovascular diseases such as stroke are increased in dialysis patients, and haemodiafiltration has been reported to reduce cerebrovascular mortality compared to haemodialysis. We wished to determine whether haemodiafiltration improves arterial stiffness. Methods: We audited aortic pulse wave velocity (PWV) measurements 6 months apart in 3 cohorts of patients: 69 treated with haemodialysis, 78 who converted from haemodialysis to haemodiafiltration and 142 treated with haemodiafiltration. Results: Cohorts were well matched for age (means ± SD: haemodialysis 64 ± 15 years vs. haemodialysis to haemodiafiltration 64 ± 17 years vs. haemodiafiltration 67 ± 16 years), sex (male 65 vs. 59 vs. 63%), diabetes (45 vs. 56.4 vs. 44%) and body mass index (26 ± 6 vs. 26 ± 5 vs. 26 ± 5), respectively. Systolic blood pressure did not differ over time (haemodialysis 143 ± 25 vs. 146 ± 27 mm Hg, haemodialysis to haemodiafiltration 153 ± 26 vs. 154 ± 25 mm Hg, haemodiafiltration 149 ± 31 vs. 148 ± 30 mm Hg) or between groups. Aortic PWV significantly increased in the haemodialysis group (9.5 ± 1.9 vs. 10.2 ± 2.2 m/s, p < 0.01) and haemodialysis to haemodiafiltration group (9.4 ± 1.9 vs. 10.1 ± 2.2 m/s, p < 0.01), but did not change with haemodiafiltration (9.9 ± 2.1 vs. 10.1 ± 2.2 m/s). Conclusions: Aortic PWV, a measure of vascular stiffness, stabilised with haemodiafiltration. Our preliminary findings require further investigation to determine how haemodiafiltration may potentially improve vascular stiffness.

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Section: Discussionmentioning

confidence: 99%

Treatment with Haemodiafiltration Stabilises Vascular Stiffness (Measured by Aortic Pulse Wave Velocity) Compared to Haemodialysis

Charitaki

Belman

Davenport³

2014

Nephron Clin Pract

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“…A study by Mostovaya et al [90] showed that OL-HDF did not improve these CV parameters over time, when compared to HD therapy.…”

Section: Hemodialysis Versus Online-hemodiafiltrationmentioning

confidence: 96%

Cardiovascular Risk Factors in End-Stage Renal Disease Patients: The Impact of Conventional Dialysis versus Online-Hemodiafiltration

Coimbra¹,

Faria²,

Miranda³

et al. 2018

Aspects in Dialysis

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End-stage renal disease (ESRD) patients present high incidence of cardiovascular (CV) events, which are the most common causes of death in these patients. The occurrence of CV events appears as a consequence of the high prevalence of traditional and nontraditional CV risk factors. Online-hemodiafiltration (OL-HDF) was introduced as a better alternative to conventional dialysis, as it was proposed to be more biocompatible, to increase dialysis efficacy, to reduce the inflammatory response to treatment and to improve patient's quality of life, contributing to reduce CV and all-cause mortality risk in ESRD. However, data in literature, comparing the effect of OL-HDF with conventional dialysis for clinical CV outcome and all-cause mortality, yielded controversy about those benefits of OL-HFD over standard hemodialysis. A review of the traditional CV risk factors (e.g., arterial hypertension, diabetes mellitus, dyslipidemia, obesity, smoking and advanced age), non-traditional risk factors (e.g., anemia, oxidative stress, hyperphosphatemia, endothelial dysfunction, left ventricular hypertrophy, insulin resistance, high levels of lipoprotein(a) and inflammation) and potential renocardiovascular biomarkers, in the setting of ESRD, is presented. The impact of conventional hemodialysis and OL-HDF on CV risk factors and on the outcome of ESRD patients is also addressed.

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“…Eine Studie aus Spanien zeigte eine geringere Mortalität in der mit Hämodiafiltration behandelten Gruppe [12]. In zwei anderen Studien (aus den Niederlanden und der Türkei) bestand keine Überlegenheit [13,19]. Dennoch zeigte eine Post-hoc-Analyse, dass die Patienten in den Gruppen mit sehr hohen Substitutionsvolumina profitierten.…”

Section: Dialyse Und Nierentransplantation Update 2014unclassified

Dialyse und Nierentransplantation

Riegel

Krüger

2014

Dtsch med Wochenschr

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A Randomized Trial of Hemodiafiltration and Change in Cardiovascular Parameters

Cited by 36 publications

References 28 publications

Treatment with Haemodiafiltration Stabilises Vascular Stiffness (Measured by Aortic Pulse Wave Velocity) Compared to Haemodialysis

Treatment with Haemodiafiltration Stabilises Vascular Stiffness (Measured by Aortic Pulse Wave Velocity) Compared to Haemodialysis

Cardiovascular Risk Factors in End-Stage Renal Disease Patients: The Impact of Conventional Dialysis versus Online-Hemodiafiltration

Dialyse und Nierentransplantation

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