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

^*Corresponding author for this work

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

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)	53-58
Number of pages	6
Journal	Blood Purification
Volume	40
Issue number	1
DOIs	https://doi.org/10.1159/000430903
Publication status	Published - Aug 2015

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@article{3c462d753e194fe4ba3d0fee19b0fb25,

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.",

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\}",

year = "2015",

month = aug,

doi = "10.1159/000430903",

language = "English",

volume = "40",

pages = "53--58",

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 - 2015/8

Y1 - 2015/8

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.

UR - https://www.scopus.com/pages/publications/84933576186

U2 - 10.1159/000430903

DO - 10.1159/000430903

M3 - Article

C2 - 26111967

AN - SCOPUS:84933576186

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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