%0 Journal Article
%T High-Target Hemodiafiltration Convective Dose Achieved in Most Patients in a 6-Month Intermediary Analysis of the CONVINCE Randomized Controlled Trial.
%A Vernooij RWM
%A Hockham C
%A Barth C
%A Canaud B
%A Cromm K
%A Davenport A
%A Hegbrant J
%A Rose M
%A Strippoli GFM
%A Török M
%A Woodward M
%A Bots ML
%A Blankestijn PJ
%J Kidney Int Rep
%V 8
%N 11
%D 2023 Nov
%M 38025213
%F 6.234
%R 10.1016/j.ekir.2023.08.004
%X <B>UNASSIGNED: </B>High convection volumes in hemodiafiltration (HDF) result in improved survival; however, it remains unclear whether it is achievable in all patients.<BR><B>UNASSIGNED: </B>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.<BR><B>UNASSIGNED: </B>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%).<BR><B>UNASSIGNED: </B>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.