Design and patient characteristics of ESHOL study, a Catalonian prospective randomized study

Maduell, Francisco; Moreso, Francesc; Pons, Mercedes; Ramos, Rosa; Mora-Macià, Josep; Foraster, Andreu; Soler, Jordi; Galcerán, J.M.; Martínez‐Castelao, Alberto

doi:10.5301/jn.2010.386

Cited by 18 publications

(7 citation statements)

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“…Clearly, further studies substantiating the potential impact of high substitution volumes in reduction of mortality are needed. The ESHOL study addressing precisely this issue has just been completed with publication of its findings imminent [17]; its results are awaited with much anticipation. Aires et al [18] have shown that on a long-term basis, optimization of convection in OL-HDF by high-volume substitution fluid is not only a safe technique but is also associated with a reduction of serum inflammatory markers.…”

Section: Clinical Experience With Ol-hdf: Focus On Improved Survival mentioning

confidence: 99%

Achieving High Convective Volumes in On-Line Hemodiafiltration

Bowry

Canaud²

2013

Blood Purif

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On-line hemodiafiltration (OL-HDF) has established itself as a highly efficient and safe form of renal replacement therapy, providing clinical benefits for several conditions that afflict end-stage chronic kidney disease patients. Additionally, evidence now ascribes a survival benefit to OL-HDF. The first indication that mortality rates decline with high-efficiency OL-HDF was provided by the European results from the DOPPS. Since then, the RISCAVID, CONTRAST and the Turkish HDF trials have all substantiated the original findings that higher convection volumes are favorable in terms of improved survival. With the emerging concept of convection volume impacting patient survival, we examine the factors and practical approaches by which maximal convection volumes can actually be achieved and individualized for each patient treated with OL-HDF. We believe that with these factors in mind, all attempts should be made to maximize convective volume, and hence the convective dose, to enable the patient to derive the full benefits of OL-HDF over extended periods.

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Section: Clinical Experience With Ol-hdf: Focus On Improved Survival mentioning

confidence: 99%

Achieving High Convective Volumes in On-Line Hemodiafiltration

Bowry

Canaud²

2013

Blood Purif

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“…However, in the CONTRAST study no benefits were found with respect to quality of life. Soon, the results of another prospective randomized multicenter open study, the Catalonian ESHOL study, will be expected after a follow-up of 3 years [58]. The aim of this study is to compare 3-year survival in 906 prevalent ESRD patients randomized to on-line HDF or high-flux HD.…”

Section: Hdf and Hard Clinical End Pointsmentioning

confidence: 99%

Effects of Hemodiafiltration on Uremic Inflammation

2013

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Chronic inflammation is highly prevalent among end-stage renal disease patients and is linked to, and thought to contribute to, the high morbidity and mortality in this patient population. Hemodiafiltration (HDF) may potentially reduce inflammatory stimuli induced by the bioincompatibility of conventional hemodialysis (HD) systems. In addition, HDF may more efficiently remove inflammatory mediators. This brief review shows that the circulating levels of various markers of systemic inflammation in general are somewhat reduced in patients treated by HDF as compared to HD. On the other hand, according to the current literature, this favorable small impact on inflammation biomarkers does not seem to translate into better clinical outcomes. It is possible that this is due to inadequate design, inadequate number of investigated patients and too short duration of previous studies. The results of larger, better-designed ongoing prospective studies may hopefully clarify this.

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“…However, both studies show significantly reduced mortality for patients treated with the highest convection volume, around 20 l. The result from a third RCT comparing outcome on HDF and HD, the Catalan study, is eagerly awaited [32]. …”

Section: Status and Outlookmentioning

confidence: 99%

Development of Hemodiafiltration Therapy - A Historical Perspective

Ledebo¹

2013

Blood Purif

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Hemodiafiltration (HDF) was created in the late 1970s to combine the best of hemodialysis (HD) and hemofiltration, i.e. superior removal of both small and large solutes. Thus, optimal conditions for both diffusion and convection are required. The need for large volumes of sterile fluid has shaped the evolution of HDF, and regulatory issues around systems for on-line fluid preparation have delayed the clinical development of the therapy. Not until such systems became generally available in the mid-1990s was it possible to increase the efficiency of HDF therapy to match and exceed the upgrade that had taken place for HD. Results from recent studies indicate that the potential for improving the outcome of dialysis lies in increasing the convective clearance of HDF above that of high-flux HD.

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Design and patient characteristics of ESHOL study, a Catalonian prospective randomized study

Cited by 18 publications

References 0 publications

Achieving High Convective Volumes in On-Line Hemodiafiltration

Achieving High Convective Volumes in On-Line Hemodiafiltration

Effects of Hemodiafiltration on Uremic Inflammation

Development of Hemodiafiltration Therapy - A Historical Perspective

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