High-Target Hemodiafiltration Convective Dose Achieved in Most Patients in a 6-Month Intermediary Analysis of the CONVINCE Randomized Controlled Trial

Robin W.M. Vernooij*, C. Hockham, C. Barth, B. Canaud, K. Cromm, A. Davenport, J. Hegbrant, M. Rose, G. F.M. Strippoli, M. Török, M. Woodward, M. L. Bots, P. J. Blankestijn

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

9 Downloads (Pure)

Abstract

Introduction: High convection volumes in hemodiafiltration (HDF) result in improved survival; however, it remains unclear whether it is achievable in all patients. Methods: 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. Results: 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%). Conclusion: 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.

Original languageEnglish
Pages (from-to)2276-2283
Number of pages8
JournalKidney International Reports
Volume8
Issue number11
DOIs
Publication statusPublished - Nov 2023

Keywords

  • baseline characteristics
  • convection volume
  • hemodiafiltration
  • hemodialysis
  • kidney failure
  • randomized controlled trial

Fingerprint

Dive into the research topics of 'High-Target Hemodiafiltration Convective Dose Achieved in Most Patients in a 6-Month Intermediary Analysis of the CONVINCE Randomized Controlled Trial'. Together they form a unique fingerprint.

Cite this