FP690HAEMODIAFILTRATION AND MORTALITY IN END STAGE KIDNEY DISEASE PATIENTS AN INDIVIDUAL PARTICIPANT DATA META-ANALYSIS OF RANDOMISED CONTROLLED TRIALS
Makaleler > Derleme · 2015
Yazarlar: Sanne Peters, Michiel Bots, Bernard Canaud, Andrew Davenport, Muriel Grooteman, Fatih Kircelli, Francesco Locatelli, Francisco Maduell, Marion Morena, Menso Nube, Ercan OK, Ferran Torres, Mark Woodward, Peter Blankestijn
Nephrology Dialysis Transplantation, Uluslararası, Wos, 2015, cilt 30, ss iii306-iii306
Özet
Introduction and Aims: Randomised controlled trials comparing haemodiafiltration (HDF) with conventional haemodialysis (HD) on mortality outcomes in end-stage kidney disease (ESKD) patients reported inconsistent results. We conducted an individual participant data meta-analysis combining data from recent trials to provide the most reliable evidence to date on the effects of HDF on mortality outcomes in ESKD patients. Methods: Individual patient data were used from four trials. Hazard ratios (HRs) and 95% confidence intervals (95% CI) comparing the effect of online HDF versus HD on all-cause, and cause-specific mortality were calculated using Cox proportional hazard models. The relationship between convection volume and the study outcomes was examined by delivered convection volume standardized to body surface area. Results: After a median follow-up of 2.5 years (1.9-3.0), 769 of the 2793 participants had died. Online HDF reduced the risk of all-cause mortality by 14% (95% CI: 1-25%), and CVD mortality by 23% (95% CI: 3-39%). The largest survival benefit was for patients receiving the highest convection volume (> 23 litre per 1.73m2 BSA per session); with a multivariable-adjusted HR of 0.78 [0.62; 0.98] for all-cause mortality and 0.69 (0.47-1.00) for CVD mortality.