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Effects of online hemodiafiltration on anemia and nutritional status in chronic hemodialysis patients

BACKGROUND: Online hemodiafiltration (OL-HDF) offers considerable advantages in clearance of molecules of various sizes. However, evidence of clinical effects of OL-HDF is scarce in Korea. In this study, we investigated changes in laboratory values over more than 12 months after switching to OL-HDF....

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Autores principales: Lee, Yu Ho, Shin, Yoon Soo, Lee, So-Young, Kim, Yang Gyun, Lee, Sang Ho, Moon, Ju Young, Jeong, Kyung Hwan, Hwang, Hyeon Seok, Ahn, Shin Young, Lee, Hong Joo, Lee, Dong-Young, Ko, Eun-Jung, Cho, Hye Jeong, Yang, Dong Ho, Jeong, Hye Yun
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Korean Society of Nephrology 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7105619/
https://www.ncbi.nlm.nih.gov/pubmed/32036641
http://dx.doi.org/10.23876/j.krcp.19.082
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author Lee, Yu Ho
Shin, Yoon Soo
Lee, So-Young
Kim, Yang Gyun
Lee, Sang Ho
Moon, Ju Young
Jeong, Kyung Hwan
Hwang, Hyeon Seok
Ahn, Shin Young
Lee, Hong Joo
Lee, Dong-Young
Ko, Eun-Jung
Cho, Hye Jeong
Yang, Dong Ho
Jeong, Hye Yun
author_facet Lee, Yu Ho
Shin, Yoon Soo
Lee, So-Young
Kim, Yang Gyun
Lee, Sang Ho
Moon, Ju Young
Jeong, Kyung Hwan
Hwang, Hyeon Seok
Ahn, Shin Young
Lee, Hong Joo
Lee, Dong-Young
Ko, Eun-Jung
Cho, Hye Jeong
Yang, Dong Ho
Jeong, Hye Yun
author_sort Lee, Yu Ho
collection PubMed
description BACKGROUND: Online hemodiafiltration (OL-HDF) offers considerable advantages in clearance of molecules of various sizes. However, evidence of clinical effects of OL-HDF is scarce in Korea. In this study, we investigated changes in laboratory values over more than 12 months after switching to OL-HDF. METHODS: Adult patients with end-stage renal disease undergoing hemodialysis (HD) were prospectively enrolled in a K-cohort (CRIS no. KCT0003281) from 6 tertiary hospitals in South Korea. We recruited 435 patients, 339 of whom were on HD at enrollment. One hundred eighty-two patients were followed for more than 24 months. Among them, 44 were switched to OL-HDF for more than 12 months without conversion to HD. We used a paired t test to compare baseline and 24-month follow-up results. RESULTS: The mean age of the subjects was 61.2 ± 12.2 years, and 62.6% were male. The baseline hemoglobin level was not significantly different between HD and OL-HDF group (10.61 ± 1.15 vs. 10.46 ± 1.03 g/dL, P = 0.437). However, the baseline serum protein and albumin levels were significantly lower in the OL-HDF group (6.82 ± 0.49 vs. 6.59 ± 0.48 g/dL, P = 0.006; 3.93 ± 0.28 vs. 3.73 ± 0.29 g/dL, P < 0.001). In patients switched to OL-HDF, levels of hemoglobin and serum albumin significantly increased (10.46 ± 1.03 vs. 11.08 ± 0.82 g/dL, P = 0.001; 3.73 ± 0.29 vs. 3.87 ± 0.30 g/dL, P = 0.001). The normalized protein catabolic rate decreased after 24 months, but the change was not significant (1.07 ± 0.25 vs. 1.03 ± 0.21 g/kg/day, P = 0.433). Although the dose of erythropoiesis-stimulating agent was lower in patients who converted to HDF, it was not significantly different (-115.7 ± 189.7 vs. -170.5 ± 257.1 P = 0.206). CONCLUSION: OL-HDF treatment over more than 12 months was associated with no harmful effects on anemia and nutritional status.
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spelling pubmed-71056192020-04-09 Effects of online hemodiafiltration on anemia and nutritional status in chronic hemodialysis patients Lee, Yu Ho Shin, Yoon Soo Lee, So-Young Kim, Yang Gyun Lee, Sang Ho Moon, Ju Young Jeong, Kyung Hwan Hwang, Hyeon Seok Ahn, Shin Young Lee, Hong Joo Lee, Dong-Young Ko, Eun-Jung Cho, Hye Jeong Yang, Dong Ho Jeong, Hye Yun Kidney Res Clin Pract Original Article BACKGROUND: Online hemodiafiltration (OL-HDF) offers considerable advantages in clearance of molecules of various sizes. However, evidence of clinical effects of OL-HDF is scarce in Korea. In this study, we investigated changes in laboratory values over more than 12 months after switching to OL-HDF. METHODS: Adult patients with end-stage renal disease undergoing hemodialysis (HD) were prospectively enrolled in a K-cohort (CRIS no. KCT0003281) from 6 tertiary hospitals in South Korea. We recruited 435 patients, 339 of whom were on HD at enrollment. One hundred eighty-two patients were followed for more than 24 months. Among them, 44 were switched to OL-HDF for more than 12 months without conversion to HD. We used a paired t test to compare baseline and 24-month follow-up results. RESULTS: The mean age of the subjects was 61.2 ± 12.2 years, and 62.6% were male. The baseline hemoglobin level was not significantly different between HD and OL-HDF group (10.61 ± 1.15 vs. 10.46 ± 1.03 g/dL, P = 0.437). However, the baseline serum protein and albumin levels were significantly lower in the OL-HDF group (6.82 ± 0.49 vs. 6.59 ± 0.48 g/dL, P = 0.006; 3.93 ± 0.28 vs. 3.73 ± 0.29 g/dL, P < 0.001). In patients switched to OL-HDF, levels of hemoglobin and serum albumin significantly increased (10.46 ± 1.03 vs. 11.08 ± 0.82 g/dL, P = 0.001; 3.73 ± 0.29 vs. 3.87 ± 0.30 g/dL, P = 0.001). The normalized protein catabolic rate decreased after 24 months, but the change was not significant (1.07 ± 0.25 vs. 1.03 ± 0.21 g/kg/day, P = 0.433). Although the dose of erythropoiesis-stimulating agent was lower in patients who converted to HDF, it was not significantly different (-115.7 ± 189.7 vs. -170.5 ± 257.1 P = 0.206). CONCLUSION: OL-HDF treatment over more than 12 months was associated with no harmful effects on anemia and nutritional status. Korean Society of Nephrology 2020-03-31 2020-03-31 /pmc/articles/PMC7105619/ /pubmed/32036641 http://dx.doi.org/10.23876/j.krcp.19.082 Text en Copyright © 2020 by The Korean Society of Nephrology This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0), which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Original Article
Lee, Yu Ho
Shin, Yoon Soo
Lee, So-Young
Kim, Yang Gyun
Lee, Sang Ho
Moon, Ju Young
Jeong, Kyung Hwan
Hwang, Hyeon Seok
Ahn, Shin Young
Lee, Hong Joo
Lee, Dong-Young
Ko, Eun-Jung
Cho, Hye Jeong
Yang, Dong Ho
Jeong, Hye Yun
Effects of online hemodiafiltration on anemia and nutritional status in chronic hemodialysis patients
title Effects of online hemodiafiltration on anemia and nutritional status in chronic hemodialysis patients
title_full Effects of online hemodiafiltration on anemia and nutritional status in chronic hemodialysis patients
title_fullStr Effects of online hemodiafiltration on anemia and nutritional status in chronic hemodialysis patients
title_full_unstemmed Effects of online hemodiafiltration on anemia and nutritional status in chronic hemodialysis patients
title_short Effects of online hemodiafiltration on anemia and nutritional status in chronic hemodialysis patients
title_sort effects of online hemodiafiltration on anemia and nutritional status in chronic hemodialysis patients
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7105619/
https://www.ncbi.nlm.nih.gov/pubmed/32036641
http://dx.doi.org/10.23876/j.krcp.19.082
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