Treatment Time or Convection Volume in HDF: What Drives the Reduced Mortality Risk?

Camiel L M de Roij van Zuijdewijn; Menso J Nubé; Piet M ter Wee; Peter J Blankestijn; Renée Lévesque; Marinus A van den Dorpel; Michiel L Bots; Muriel P C Grooteman

doi:10.1159/000430903

Treatment Time or Convection Volume in HDF: What Drives the Reduced Mortality Risk?

Camiel L M de Roij van Zuijdewijn
, Menso J Nubé
, Piet M ter Wee
, Peter J Blankestijn
, Renée Lévesque
, Marinus A van den Dorpel
, Michiel L Bots
, Muriel P C Grooteman

Research output: Contribution to journal › Article › Academic › peer-review

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Abstract

BACKGROUND/AIMS: Treatment time is associated with survival in hemodialysis (HD) patients and with convection volume in hemodiafiltration (HDF) patients. High-volume HDF is associated with improved survival. Therefore, we investigated whether this survival benefit is explained by treatment time.

METHODS: Participants were subdivided into four groups: HD and tertiles of convection volume in HDF. Three Cox regression models were fitted to calculate hazard ratios (HRs) for mortality of HDF subgroups versus HD: (1) crude, (2) adjusted for confounders, (3) model 2 plus mean treatment time. As the only difference between the latter models is treatment time, any change in HRs is due to this variable.

RESULTS: 114/700 analyzed individuals were treated with high-volume HDF. HRs of high-volume HDF are 0.61, 0.62 and 0.64 in the three models, respectively (p values <0.05). Confidence intervals of models 2 and 3 overlap.

CONCLUSION: The survival benefit of high-volume HDF over HD is independent of treatment time.

Original language	English
Pages (from-to)	53-8
Number of pages	6
Journal	Blood purification
Volume	40
Issue number	1
DOIs	https://doi.org/10.1159/000430903
Publication status	Published - 2015

Keywords

Adult
Aged
Female
Follow-Up Studies
Hemodiafiltration/methods
Humans
Kidney Failure, Chronic/mortality
Male
Middle Aged
Time Factors
Treatment Outcome

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title = "Treatment Time or Convection Volume in HDF: What Drives the Reduced Mortality Risk?",

abstract = "BACKGROUND/AIMS: Treatment time is associated with survival in hemodialysis (HD) patients and with convection volume in hemodiafiltration (HDF) patients. High-volume HDF is associated with improved survival. Therefore, we investigated whether this survival benefit is explained by treatment time.METHODS: Participants were subdivided into four groups: HD and tertiles of convection volume in HDF. Three Cox regression models were fitted to calculate hazard ratios (HRs) for mortality of HDF subgroups versus HD: (1) crude, (2) adjusted for confounders, (3) model 2 plus mean treatment time. As the only difference between the latter models is treatment time, any change in HRs is due to this variable.RESULTS: 114/700 analyzed individuals were treated with high-volume HDF. HRs of high-volume HDF are 0.61, 0.62 and 0.64 in the three models, respectively (p values <0.05). Confidence intervals of models 2 and 3 overlap.CONCLUSION: The survival benefit of high-volume HDF over HD is independent of treatment time.",

keywords = "Adult, Aged, Female, Follow-Up Studies, Hemodiafiltration/methods, Humans, Kidney Failure, Chronic/mortality, Male, Middle Aged, Time Factors, Treatment Outcome",

author = "\{de Roij van Zuijdewijn\}, \{Camiel L M\} and Nub{\'e}, \{Menso J\} and \{ter Wee\}, \{Piet M\} and Blankestijn, \{Peter J\} and Ren{\'e}e L{\'e}vesque and \{van den Dorpel\}, \{Marinus A\} and Bots, \{Michiel L\} and Grooteman, \{Muriel P C\}",

note = "{\textcopyright} 2015 S. Karger AG, Basel.",

year = "2015",

doi = "10.1159/000430903",

language = "English",

volume = "40",

pages = "53--8",

journal = "Blood purification",

issn = "0253-5068",

publisher = "S. Karger AG",

number = "1",

}

TY - JOUR

T1 - Treatment Time or Convection Volume in HDF

T2 - What Drives the Reduced Mortality Risk?

AU - de Roij van Zuijdewijn, Camiel L M

AU - Nubé, Menso J

AU - ter Wee, Piet M

AU - Blankestijn, Peter J

AU - Lévesque, Renée

AU - van den Dorpel, Marinus A

AU - Bots, Michiel L

AU - Grooteman, Muriel P C

PY - 2015

Y1 - 2015

N2 - BACKGROUND/AIMS: Treatment time is associated with survival in hemodialysis (HD) patients and with convection volume in hemodiafiltration (HDF) patients. High-volume HDF is associated with improved survival. Therefore, we investigated whether this survival benefit is explained by treatment time.METHODS: Participants were subdivided into four groups: HD and tertiles of convection volume in HDF. Three Cox regression models were fitted to calculate hazard ratios (HRs) for mortality of HDF subgroups versus HD: (1) crude, (2) adjusted for confounders, (3) model 2 plus mean treatment time. As the only difference between the latter models is treatment time, any change in HRs is due to this variable.RESULTS: 114/700 analyzed individuals were treated with high-volume HDF. HRs of high-volume HDF are 0.61, 0.62 and 0.64 in the three models, respectively (p values <0.05). Confidence intervals of models 2 and 3 overlap.CONCLUSION: The survival benefit of high-volume HDF over HD is independent of treatment time.

AB - BACKGROUND/AIMS: Treatment time is associated with survival in hemodialysis (HD) patients and with convection volume in hemodiafiltration (HDF) patients. High-volume HDF is associated with improved survival. Therefore, we investigated whether this survival benefit is explained by treatment time.METHODS: Participants were subdivided into four groups: HD and tertiles of convection volume in HDF. Three Cox regression models were fitted to calculate hazard ratios (HRs) for mortality of HDF subgroups versus HD: (1) crude, (2) adjusted for confounders, (3) model 2 plus mean treatment time. As the only difference between the latter models is treatment time, any change in HRs is due to this variable.RESULTS: 114/700 analyzed individuals were treated with high-volume HDF. HRs of high-volume HDF are 0.61, 0.62 and 0.64 in the three models, respectively (p values <0.05). Confidence intervals of models 2 and 3 overlap.CONCLUSION: The survival benefit of high-volume HDF over HD is independent of treatment time.

KW - Adult

KW - Aged

KW - Female

KW - Follow-Up Studies

KW - Hemodiafiltration/methods

KW - Humans

KW - Kidney Failure, Chronic/mortality

KW - Male

KW - Middle Aged

KW - Time Factors

KW - Treatment Outcome

U2 - 10.1159/000430903

DO - 10.1159/000430903

M3 - Article

SN - 0253-5068

VL - 40

SP - 53

EP - 58

JO - Blood purification

JF - Blood purification

IS - 1

ER -

Treatment Time or Convection Volume in HDF: What Drives the Reduced Mortality Risk?

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Keywords

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