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

Yu Ho Lee, Yoon Soo Shin, So Young Lee, Yang Gyun Kim, Sang Ho Lee, Ju Young Moon, Kyung Hwan Jeong, Hyeon Seok Hwang, Shin Young Ahn, Hong Joo Lee, Dong Young Lee, Eun Jung Ko, Hye Jeong Cho, Dong Ho Yang, Hye Yun Jeong

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1 Citation (Scopus)

Abstract

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.

Original languageEnglish
Pages (from-to)103-111
Number of pages9
JournalKidney Research and Clinical Practice
Volume39
Issue number1
DOIs
Publication statusPublished - 2020

Keywords

  • Anemia
  • Chronic
  • Dialysis
  • Hemodiafiltration
  • Kidney failure
  • Nutritional status

ASJC Scopus subject areas

  • Nephrology
  • Urology

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