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- Title
Online hemodiafiltration reduces systemic inflammation compared to low-flux hemodialysis.
- Authors
den Hoedt, Claire H; Bots, Michiel L; Grooteman, Muriel P C; van der Weerd, Neelke C; Mazairac, Albert H A; Penne, E. Lars; Levesque, Renée; ter Wee, Piet M; Nubé, Menso J; Blankestijn, Peter J; van den Dorpel, Marinus A
- Abstract
Online hemodiafiltration may diminish inflammatory activity through amelioration of the uremic milieu. However, impurities in water quality might provoke inflammatory responses. We therefore compared the long-term effect of low-flux hemodialysis to hemodiafiltration on the systemic inflammatory activity in a randomized controlled trial. High-sensitivity C-reactive protein and interleukin-6 were measured for up to 3 years in 405 patients of the CONvective TRAnsport STudy, and albumin was measured at baseline and every 3 months in 714 patients during the entire follow-up. Differences in the rate of change over time of C-reactive protein, interleukin-6, and albumin were compared between the two treatment arms. C-reactive protein and interleukin-6 concentrations increased in patients treated with hemodialysis, and remained stable in patients treated with hemodiafiltration. There was a statistically significant difference in rate of change between the groups after adjustments for baseline variables (C-reactive protein difference 20%/year and interleukin-6 difference 16%/year). The difference was more pronounced in anuric patients. Serum albumin decreased significantly in both treatment arms, with no difference between the groups. Thus, long-term hemodiafiltration with ultrapure dialysate seems to reduce inflammatory activity over time compared to hemodialysis, but does not affect the rate of change in albumin.
- Subjects
HEMODIALYSIS; INFLAMMATION treatment; C-reactive protein; INTERLEUKIN-6; DIALYSIS (Chemistry); UREMIA
- Publication
Kidney International, 2014, Vol 86, Issue 2, p423
- ISSN
0085-2538
- Publication type
Article
- DOI
10.1038/ki.2014.9