학술논문
Treatment tolerance and patient-reported outcomes favor online hemodiafiltration compared to high-flux hemodialysis in the elderly
Document Type
Article
Author
Morena, Marion; Jaussent, Audrey; Chalabi, Lotfi; Leray-Moragues, Hélène; Chenine, Leila; Debure, Alain; Thibaudin, Damien; Azzouz, Lynda; Patrier, Laure; Maurice, Francois; Nicoud, Philippe; Durand, Claude; Seigneuric, Bruno; Dupuy, Anne-Marie; Picot, Marie-Christine; Cristol, Jean-Paul; Canaud, Bernard; Afiani, Aida; Aguilera, Didier; Azymah, Yamina; Azzouz, Lynda; Babinet, Francois; Belloc, Claire; Bendini, Jean- Christophe; Broyet, Christian; Brunet, Philippe; Canaud, Bernard; Chabannier, Marie-Hélène; Chalabi, Lotfi; Chenine, Leïla; Chiron, Sylvie; Coindre, Jean-Philippe; Colin, Angélique; Combarnous, François; Coupel, Stéphanie; Cremault, Alain; Cristol, Jean-Paul; Dancea, Irima; Debure, Alain; Delcroix, Catherine; Depraetre, Pascale; Djema, Assia; Ducret, Francis; Durand, Claude; Farah, Ibrahim; Fleury, Dominique; Guerraoui, Abdallah; Guillodo, Marie-Paule; Haddj-Elmrabet, Atman; Hoffmann, Maxime; Ibos, Richard; Islam, Mohamed Shariful; Jaubert, Dominique; Jaussent, Audrey; Joule, Josiane; Joyeux, Véronique; Kunz, Kristian; Lagarrigue, Mélodie; Laradi, Achour; Lavainne, Frédéric; Le Grignou, Dominique; Lebrun, Gaétan; Lefebvre, Anne; Lefevre, Jean-Jacques; Lefrancois, Gaëlle; Lemaitre, Vincent; Leray-Moragues, Hélène; Maaz, Mehadji; Magnant, Eric; Maurice, François; Mohey, Hesham; Morena, Marion; Nicoud, Philippe; Normand, Michel; Nzeyimana, Hilaire; Ouziala, Messaoud; Parahy, Sophie; Patrier, Laure; Perrin, Franck; Picot, Marie-Christine; Pointet, Philippe; Potier, Jacky; Puyoo, Olivier; Rey, Isabelle; Rivory, Jean-Pierre; Rouleau, Fabienne; Seigneuric, Bruno; Serveaux, Marie-Odile; Simonin, Danièle; Testa, Angelo; Thibaudin, Damien; Turc-Baron, Cécile; Vela, Carlos; Vido, Sandor; Vrigneaud, Laurence
Source
Kidney International; June 2017, Vol. 91 Issue: 6 p1495-1509, 15p
Subject
Language
ISSN
00852538; 15231755
Abstract
Large cohort studies suggest that high convective volumes associated with online hemodiafiltration may reduce the risk of mortality/morbidity compared to optimal high-flux hemodialysis. By contrast, intradialytic tolerance is not well studied. The aim of the FRENCHIE (French Convective versus Hemodialysis in Elderly) study was to compare high-flux hemodialysis and online hemodiafiltration in terms of intradialytic tolerance. In this prospective, open-label randomized controlled trial, 381 elderly chronic hemodialysis patients (over age 65) were randomly assigned in a one-to-one ratio to either high-flux hemodialysis or online hemodiafiltration. The primary outcome was intradialytic tolerance (day 30–day 120). Secondary outcomes included health-related quality of life, cardiovascular risk biomarkers, morbidity, and mortality. During the observational period for intradialytic tolerance, 85% and 84% of patients in high-flux hemodialysis and online hemodiafiltration arms, respectively, experienced at least one adverse event without significant difference between groups. As exploratory analysis, intradialytic tolerance was also studied, considering the sessions as a statistical unit according to treatment actually received. Over a total of 11,981 sessions, 2,935 were complicated by the occurrence of at least one adverse event, with a significantly lower occurrence in online hemodiafiltration with fewer episodes of intradialytic symptomatic hypotension and muscle cramps. By contrast, health-related quality of life, morbidity, and mortality were not different in both groups. An improvement in the control of metabolic bone disease biomarkers and β2-microglobulin level without change in serum albumin concentration was observed with online hemodiafiltration. Thus, overall outcomes favor online hemodiafiltration over high-flux hemodialysis in the elderly.