Global real‐world data on hemodiafiltration: An opportunity to complement clinical trial evidence

Ficociello, Linda H.; Busink, Ellen; Sawin, Dixie-Ann; Winter, Anke

doi:10.1111/sdi.13085

Cited by 3 publications

(1 citation statement)

References 61 publications

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“…Online hemodiafiltration (OL-HDF) attenuates HD-associated systemic inflammation, reducing proinflammatory CD14+ CD16+ monocyte-derived dendritic cells and cytokine levels in the serum of dialysis patients [26,27]. Several observational studies and four randomized controlled trials (RCT) suggest an overall survival benefit from the implementation of high-volume OL-HDF as opposed to conventional low-or high-flux HD [28,29]. A French RCT demonstrated improved treatment tolerance of OL-HDF but no effect on morbidity and mortality compared with high-flux HD in elderly patients [30].…”

Section: Introductionmentioning

confidence: 99%

Dialysis Patients Respond Adequately to Influenza Vaccination Irrespective of Dialysis Modality and Chronic Inflammation

Pleros,

Adamidis,

Kantartzi

et al. 2023

JCM

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(1) Background: Chronic inflammation and suboptimal immune responses to vaccinations are considered to be aspects of immune dysregulation in patients that are undergoing dialysis. The present study aimed to evaluate immune responses in hemodialysis (HD) and online hemodiafiltration (OL-HDF) patients to a seasonal inactivated quadrivalent influenza vaccine (IQIV). (2) Methods: We enrolled 172 chronic dialysis patients (87 on HD and 85 on OL-HDF) and 18 control subjects without chronic kidney disease in a prospective, cross-sectional cohort study. Participants were vaccinated with a seasonal IQIV, and antibody titers using the hemagglutination inhibition (HI) assay were determined before vaccination (month 0) and 1, 3, and 6 months thereafter. Demographics and inflammatory markers (CRP, IL-6, IL-1β) were recorded at month 0. The primary endpoints were the rates of seroresponse (SR), defined as a four-fold increase in the HI titer, and seroprotection (SP), defined as HI titer ≥ 1/40 throughout the study period. Statistical analyses were conducted in R (version 3.6.3) statistical software. The differences between groups were analyzed using chi-square and t-test analyses for dichotomous and continuous variables, respectively. To identify independent determinants of SR and SP, generalized linear models were built with response or protection per virus strain as the dependent variable and group, age, sex, time (month 0, 1, 3, 6), diabetes, IL-6, dialysis vintage, HD access, and HDF volume as independent explanatory variables. (3) Results: SR and SP rates were similar between control subjects, and dialysis patients were not affected by dialysis modality. SP rates were high (> 70%) at the beginning of the study and practically reached 100% after vaccination in all study groups. These results applied to all four virus strains that were included in the IQIV. IL-6 levels significantly differed between study groups, with HD patients displaying the highest values, but this did not affect SP rates. (4) Conclusions: Dialysis patients respond to influenza immunization adequately and similarly to the general population. Thus, annual vaccination policies should be encouraged in dialysis units. OL-HDF reduces chronic inflammation; however, this has no impact on SR rates.

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Section: Introductionmentioning

confidence: 99%

Dialysis Patients Respond Adequately to Influenza Vaccination Irrespective of Dialysis Modality and Chronic Inflammation

Pleros,

Adamidis,

Kantartzi

et al. 2023

JCM

View full text Add to dashboard Cite

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Global real‐world data on hemodiafiltration: An opportunity to complement clinical trial evidence

Ficociello

Busink

Sawin

et al. 2022

Seminars in Dialysis

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Hemodiafiltration (HDF) is a renal replacement therapy that utilizes both diffusive clearance and convective transport to achieve greater clearance of middle-molecularweight solutes. Among other factors, important prerequisites for the implementation of HDF include access to high-flux dialyzers, achievement of high blood flow rates, and availability of high volumes of sterile substitution/replacement fluids. Online hemodiafiltration (OL-HDF) is an established kidney replacement therapy, frequently used in many countries. Although in the United States, some prerequisites (e.g., access to high-flux dialyzers and achievement of high blood flow rates) for OL-HDF treatment are readily available; however, a machine capable of generating the online solution for OL-HDF is currently not available. As the clinical experience with HDF accumulates globally, it is worth examining the evidence for this kidney replacement therapy as used in routine clinical care. Such real-world evidence is increasingly recognized as valuable by clinicians and may inform regulatory decisions. In this review, we will focus on emerging global real-world data derived from routine clinical practices and examine how these data may complement those derived from clinical trials.

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Circadian-like patterns in electrochemical skin conductance measured from home-based devices: a retrospective study

Vittrant,

Courrier,

Yang

et al. 2023

Front. Neurol.

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In this study, we investigated the potential of electrochemical skin conductance (ESC) measurements gathered from home-based devices to detect circadian-like patterns. We analyzed data from 43,284 individuals using the Withings Body Comp or Body Scan scales, which provide ESC measurements. Our results highlighted a circadian pattern of ESC values across different age groups and countries. Our findings suggest that home-based ESC measurements could be used to evaluate circadian rhythm disorders associated with neuropathies and contribute to a better understanding of their pathophysiology. However, further controlled studies are needed to confirm these results. This study highlights the potential of digital health devices to generate new scientific and medical knowledge.

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Global real‐world data on hemodiafiltration: An opportunity to complement clinical trial evidence

Cited by 3 publications

References 61 publications

Dialysis Patients Respond Adequately to Influenza Vaccination Irrespective of Dialysis Modality and Chronic Inflammation

Dialysis Patients Respond Adequately to Influenza Vaccination Irrespective of Dialysis Modality and Chronic Inflammation

Global real‐world data on hemodiafiltration: An opportunity to complement clinical trial evidence

Circadian-like patterns in electrochemical skin conductance measured from home-based devices: a retrospective study

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