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dc.contributor.authorVilar, Enric
dc.contributor.authorFry, A.C.
dc.contributor.authorWellsted, D.
dc.contributor.authorTattersall, J.E.
dc.contributor.authorGreenwood, R.N.
dc.contributor.authorFarrington, Ken
dc.identifier.citationVilar , E , Fry , A C , Wellsted , D , Tattersall , J E , Greenwood , R N & Farrington , K 2009 , ' Long-Term Outcomes in Online Hemodiafiltration and High-Flux Hemodialysis : A Comparative Analysis ' , Clinical Journal of the American Society of Nephrology , vol. 4 , no. 12 , pp. 1944-1953 .
dc.identifier.otherPURE: 116147
dc.identifier.otherPURE UUID: 9d559464-2aee-4662-b794-dad4ed100339
dc.identifier.otherdspace: 2299/4131
dc.identifier.otherScopus: 73649088259
dc.descriptionOriginal article can be found at: Copyright American Society of Nephrology. [Full text of this article is not available in the UHRA]
dc.description.abstractBackground and objectives: Theoretical advantages exist of online hemodiafiltration (HDF) over high-flux hemodialysis (HD), but outcome data are scarce. Our objective was to compare outcomes between these modalities. Design, setting, participants, & measurements: We studied 858 incident patients in our incremental high-flux HD and online HDF program during an 18-yr period. We compared outcomes, including survival, in those who were treated predominantly with HDF (>50% sessions) and those with high-flux HD. Survival comparisons used a Cox model taking into account the time-varying proportion of time spent on HDF. All data were prospectively collected. Results: A total of 152,043 sessions were delivered as HDF and 291,222 as high-flux HD. A total of 232 (27%) patients were treated predominantly with HDF and 626 (73%) with high-flux HD. Total Kt/V, serum albumin, erythropoietin resistance index, and BP were similar in both groups up to 5 yr after HD initiation. Intradialytic hypotension was less frequent in the predominant HDF group. Predominant HDF treatment was associated with a reduced risk for death after correction for confounding variables. In a second Cox model, proportion of time spent on HDF predicted survival, such that patients who were treated solely by HDF would have a hazard for death of 0.66 compared with those who solely used high-flux HD. Conclusions: We found no benefits of HDF over high-flux HD with respect to anemia management, nutrition, mineral metabolism, and BP control. The mortality benefit associated with HDF requires confirmation in large randomized, controlled trials. These data may contribute to their design.en
dc.relation.ispartofClinical Journal of the American Society of Nephrology
dc.titleLong-Term Outcomes in Online Hemodiafiltration and High-Flux Hemodialysis : A Comparative Analysisen
dc.contributor.institutionSchool of Life and Medical Sciences
dc.contributor.institutionDepartment of Psychology
dc.contributor.institutionHealth & Human Sciences Research Institute
dc.contributor.institutionCentre for Lifespan and Chronic Illness Research
dc.contributor.institutionHealth Services and Medicine
dc.contributor.institutionApplied and Practice-based Research
dc.contributor.institutionHealth and Clinical Psychology group
dc.contributor.institutionCentre for Health Services and Clinical Research
dc.contributor.institutionDepartment of Pharmacy, Pharmacology and Postgraduate Medicine
dc.description.statusPeer reviewed
dc.relation.schoolSchool of Life and Medical Sciences
rioxxterms.typeJournal Article/Review

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