Can Dialysis Modality Influence Quality of Life in Chronic Hemodialysis Patients? Low-Flux Hemodialysis versus High-Flux Hemodiafiltration: A Cross-Over Study

Kantartzi, Konstantia; Panagoutsos, Stelios; Mourvati, E; Roumeliotis, Athanasios; Leivaditis, Konstantinos; Devetzis, Vassilios; Passadakis, Ploumis; Vargemezis, Vassilios

doi:10.3109/0886022x.2012.743858

Cited by 33 publications

(43 citation statements)

References 27 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Dialysis innovations that have entered routine clinical use, such as hemodiafiltration or high-flux hemodialysis, are demonstrated improved clinical outcomes. 11,12 In this research, we used the FX60 dialyzer, and compared it with the NIPRO-130G, to analyze the outcomes of dialysis in the same patient population. During the three-year FX60 dialyzer follow-up period, b2-MG and NT-proBNP levels decreased significantly (p50.05), and MAP and LVEF improved compared to the pre-HFHD period.…”

Section: Discussionmentioning

confidence: 99%

Clinical outcomes for maintenance hemodialysis patients using a high-flux (FX60) dialyzer

Wang

et al. 2013

Renal Failure

View full text Add to dashboard Cite

Aims: To investigate the clinical outcomes of maintenance hemodialysis (HD) patients using a high-flux (FX60) dialyzer. Method: Thirty patients undergoing dialysis for at least 2 years with a low-flux dialyzer were switched to the FX60 dialyzer for 3 years. Clinical and biochemical analysis was performed monthly for each patient. The parameters monitored included blood pressure, hemoglobin, albumin, intact parathyroid hormone (iPTH), calcium and phosphorus levels, the adequacy of dialysis (Kt/V), beta2-microglobulin (b2-MG) clearance rate, as well as antihypertensive and erythropoietin (EPO) medications. Results: After 3 years of dialysis with an FX60 dialyzer, the mean arterial blood pressure fell, hemoglobin increased, serum phosphate level decreased, iPTH declined and medication doses decreased. Conclusions: Dialysis with the FX60 dialyzer has a better clinical outcome for rectifying renal anemia, controlling hypertension and lowering serum phosphate levels making it a better choice for long-term HD patients.

show abstract

Section: Discussionmentioning

confidence: 99%

Clinical outcomes for maintenance hemodialysis patients using a high-flux (FX60) dialyzer

Wang

et al. 2013

Renal Failure

View full text Add to dashboard Cite

show abstract

“…End-stage kidney disease has a significant and deleterious impact on duration and quality of life 1, 2, 3, 4. Approximately 1.9 million patients receive renal replacement therapy worldwide 5 .…”

mentioning

confidence: 99%

A Randomized, Single-Blind, Crossover Trial of Recovery Time in High-Flux Hemodialysis and Hemodiafiltration

Smith

Zimmer

Bell

et al. 2017

American Journal of Kidney Diseases

View full text Add to dashboard Cite

BackgroundThe choice between hemodiafiltration (HDF) or high-flux hemodialysis (HD) to treat end-stage kidney disease remains a matter of debate. The duration of recovery time after treatment has been associated with mortality, affects quality of life, and may therefore be important in informing patient choice. We aimed to establish whether recovery time is influenced by treatment with HDF or HD.Study DesignRandomized patient-blinded crossover trial.Settings & Participants100 patients with end-stage kidney disease were enrolled from 2 satellite dialysis units in Glasgow, United Kingdom.Intervention8 weeks of HD followed by 8 weeks of online postdilution HDF or vice versa.OutcomesPosttreatment recovery time, symptomatic hypotension events, dialysis circuit clotting events, and biochemical parameters.MeasurementsPatient-reported recovery time in minutes, incidence of adverse events during treatments, hematology and biochemistry results, quality-of-life questionnaire.ResultsThere was no overall difference in recovery time between treatments (medians for HDF vs HD of 47.5 [IQR, 0-240] vs 30 [IQR, 0-210] minutes, respectively; P = 0.9). During HDF treatment, there were significant increases in rates of symptomatic hypotension (8.0% in HDF vs 5.3% in HD; relative risk [RR], 1.52; 95% CI, 1.2-1.9; P < 0.001) and intradialytic tendency to clotting (1.8% in HDF vs 0.7% in HD; RR, 2.7; 95% CI, 1.5-5.0; P = 0.002). Serum albumin level was significantly lower during HDF (3.2 vs 3.3 g/dL; P < 0.001). Health-related quality-of-life scores were equivalent.LimitationsSingle center; mean achieved HDF convection volume, 20.6 L.ConclusionsPatients blinded to whether they were receiving HD or HDF in a randomized controlled crossover study reported similar posttreatment recovery times and health-related quality-of-life scores.

show abstract

“…We did not identify any effect of membrane flux on the SF-36 score. There are few studies on quality of life according to dialysis technique, and those that exist mainly show improvement with convective techniques compared to low-flux dialysis [24,25]. Haemodiafiltration was not used in our study.…”

Section: Discussionmentioning

confidence: 99%

Effect of Membrane Permeability on Cardiovascular Risk Factors and β2m Plasma Levels in Patients on Long-Term Haemodialysis: A Randomised Crossover Trial

Chazot

Kirchgessner²,

Pham³

et al. 2015

Nephron

View full text Add to dashboard Cite

Survival of haemodialysis (HD) patients is influenced by many factors. Mortality is mainly of cardiovascular (CV) origin and related to both traditional and nontraditional CV risk factors. Low plasma Beta2-microglobulin (β2m) levels are associated with improved HD patient survival. HD session times that are longer than the conventional 4 h (i.e., extended dialysis) provide better middle molecule clearance and are also associated with a survival advantage. In this crossover randomised trial, we investigated the effect of membrane flux on CV risk factors and on β2m plasma levels in patients treated with extended dialysis. Dialysis session duration was between 5 and 8 h for all patients. Patients were randomly assigned to the treatment sequences low-flux/high-flux dialysis versus high-flux/low-flux dialysis in a crossover design after a 3-month run-in period, with each phase lasting 9 months. Of the initially enrolled 168 patients, 155 patients started the study after the run-in period, 117 patients completed Phase 1, and 83 patients completed the whole study. Lp(a), homocystein, LDL cholesterol, HDL cholesterol and serum albumin were comparable in the low-flux and high-flux treatments. The average β2m level was 43.3 ± 11.1 mg/l at the end of the low-flux phase. Independent of sequence assignation, average β2m was significantly lower at the end of the high-flux phase (27.5 ± 76.0 mg/l, p < 0.0001 versus end of low-flux phase). Both phosphate and nPNA were significantly lower at the end of the high-flux phase compared to the low-flux phase (p = 0.045 and p = 0.002, respectively). Inclusion of those patients who completed Phase 1 and who dropped out of the study during Phase 2 did not significantly change the results. In conclusion, this study did not find an influence of high-flux filters on several traditional CV risk factors in a population of HD patients treated with extended dialysis. However, high-flux filters are necessary to optimise middle molecule clearance and reduce the β2m level.

show abstract

Can Dialysis Modality Influence Quality of Life in Chronic Hemodialysis Patients? Low-Flux Hemodialysis versus High-Flux Hemodiafiltration: A Cross-Over Study

Cited by 33 publications

References 27 publications

Clinical outcomes for maintenance hemodialysis patients using a high-flux (FX60) dialyzer

Clinical outcomes for maintenance hemodialysis patients using a high-flux (FX60) dialyzer

A Randomized, Single-Blind, Crossover Trial of Recovery Time in High-Flux Hemodialysis and Hemodiafiltration

Effect of Membrane Permeability on Cardiovascular Risk Factors and β2m Plasma Levels in Patients on Long-Term Haemodialysis: A Randomised Crossover Trial

Contact Info

Product

Resources

About