PDF(Pubmed)
Abstract：
UNASSIGNED: High convection volumes in hemodiafiltration (HDF) result in improved survival; however, it remains unclear whether it is achievable in all patients.
UNASSIGNED: CONVINCE, a randomized controlled trial, randomized patients with end-stage kidney disease 1:1 to high-dose HDF versus high-flux hemodialysis (HD) continuation. We evaluated the proportion of patients achieving high-dose HDF target: convection volume per visit of ≥23 l (range ±1 l) at baseline, month 3, and month 6. We compared baseline characteristics in the following 2 ways: (i) patients on target for all 3 visits versus patients who missed target on ≥1 visits and (ii) patients on target for all 3 visits or missing it once versus patients who missed target on ≥2 visits.
UNASSIGNED: A total of 653 patients were randomized to HDF. Their mean age was 62.2 (SD 13.5) years, 36% were female, 81% had fistula vascular access, and 33% had diabetes. Across the 3 visits, 75 patients (11%), 27 patients (4%), and 11 patients (2%) missed the convection volume target once, twice, and thrice, respectively. Apart from diabetes, there were no apparent differences in patient characteristics between patients who always achieved the high-dose target (83%) and those who missed the target either once or more (17%) or twice or more (6%).
UNASSIGNED: Achieving high-dose HDF is feasible for nearly all patients in CONVINCE and could be maintained during the 6-month follow-up period. Apart from diabetes, there were no other indications for confounding by indication on multivariable analyses that may explain the potential survival advantage for patients receiving high-dose HDF.
UNASSIGNED: CONVINCE, a randomized controlled trial, randomized patients with end-stage kidney disease 1:1 to high-dose HDF versus high-flux hemodialysis (HD) continuation. We evaluated the proportion of patients achieving high-dose HDF target: convection volume per visit of ≥23 l (range ±1 l) at baseline, month 3, and month 6. We compared baseline characteristics in the following 2 ways: (i) patients on target for all 3 visits versus patients who missed target on ≥1 visits and (ii) patients on target for all 3 visits or missing it once versus patients who missed target on ≥2 visits.
UNASSIGNED: A total of 653 patients were randomized to HDF. Their mean age was 62.2 (SD 13.5) years, 36% were female, 81% had fistula vascular access, and 33% had diabetes. Across the 3 visits, 75 patients (11%), 27 patients (4%), and 11 patients (2%) missed the convection volume target once, twice, and thrice, respectively. Apart from diabetes, there were no apparent differences in patient characteristics between patients who always achieved the high-dose target (83%) and those who missed the target either once or more (17%) or twice or more (6%).
UNASSIGNED: Achieving high-dose HDF is feasible for nearly all patients in CONVINCE and could be maintained during the 6-month follow-up period. Apart from diabetes, there were no other indications for confounding by indication on multivariable analyses that may explain the potential survival advantage for patients receiving high-dose HDF.
摘要：
■血液透析滤过（HDF）的高对流量可提高生存率；然而，目前尚不清楚是否可以在所有患者中实现.
■宣传，一项随机对照试验,1:1随机分配终末期肾病患者接受大剂量HDF与高通量血液透析(HD)延续治疗.我们评估了达到高剂量HDF目标的患者比例：基线时每次就诊的对流量≥23l（范围±1l），3月和6月。我们以以下两种方式比较了基线特征：（i）所有3次就诊的目标患者与≥1次就诊时错过目标的患者，以及（ii）所有3次就诊的目标患者或一次错过目标患者与≥2次就诊时错过目标的患者。
■总共653名患者被随机分配到HDF。他们的平均年龄为62.2(标准差13.5)岁，36%是女性,81%有瘘管血管通路,33%患有糖尿病。在3次访问中，75名患者（11%），27名患者（4%），11名患者（2%）一次未能达到对流量目标，两次,三次，分别。除了糖尿病,始终达到高剂量目标(83%)的患者与一次或多次(17%)或两次或两次以上(6%)未达到目标的患者之间,患者特征没有明显差异.
■实现高剂量HDF对于几乎所有CONVINCE患者都是可行的，并且可以在6个月的随访期内维持。除了糖尿病,在多变量分析中,没有其他可解释接受大剂量HDF的患者潜在生存优势的适应症混杂.
■宣传，一项随机对照试验,1:1随机分配终末期肾病患者接受大剂量HDF与高通量血液透析(HD)延续治疗.我们评估了达到高剂量HDF目标的患者比例：基线时每次就诊的对流量≥23l（范围±1l），3月和6月。我们以以下两种方式比较了基线特征：（i）所有3次就诊的目标患者与≥1次就诊时错过目标的患者，以及（ii）所有3次就诊的目标患者或一次错过目标患者与≥2次就诊时错过目标的患者。
■总共653名患者被随机分配到HDF。他们的平均年龄为62.2(标准差13.5)岁，36%是女性,81%有瘘管血管通路,33%患有糖尿病。在3次访问中，75名患者（11%），27名患者（4%），11名患者（2%）一次未能达到对流量目标，两次,三次，分别。除了糖尿病,始终达到高剂量目标(83%)的患者与一次或多次(17%)或两次或两次以上(6%)未达到目标的患者之间,患者特征没有明显差异.
■实现高剂量HDF对于几乎所有CONVINCE患者都是可行的，并且可以在6个月的随访期内维持。除了糖尿病,在多变量分析中,没有其他可解释接受大剂量HDF的患者潜在生存优势的适应症混杂.
