Effects of online hemodiafiltration on anemia and nutritional status in chronic hemodialysis patients

Yu Ho Lee; Yoon Soo Shin; So Young Lee; Yang Gyun Kim; Sang Ho Lee; Ju Young Moon; Kyung Hwan Jeong; Hyeon Seok Hwang; Shin Young Ahn; Hong Joo Lee; Dong Young Lee; Eun Jung Ko; Hye Jeong Cho; Dong Ho Yang; Hye Yun Jeong

doi:10.23876/j.krcp.19.082

Effects of online hemodiafiltration on anemia and nutritional status in chronic hemodialysis patients

Yu Ho Lee, Yoon Soo Shin, So Young Lee, Yang Gyun Kim, Sang Ho Lee, Ju Young Moon, Kyung Hwan Jeong, Hyeon Seok Hwang, Shin Young Ahn, Hong Joo Lee, Dong Young Lee, Eun Jung Ko, Hye Jeong Cho, Dong Ho Yang, Hye Yun Jeong

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6 Citations (Scopus)

Abstract

Background: Online hemodiafiltration (OL-HDF) offers considerable advantages in clearance of molecules of various sizes. However, evidence of clinical effects of OL-HDF is scarce in Korea. In this study, we investigated changes in laboratory values over more than 12 months after switching to OL-HDF. Methods: Adult patients with end-stage renal disease undergoing hemodialysis (HD) were prospectively enrolled in a K-cohort (CRIS no. KCT0003281) from 6 tertiary hospitals in South Korea. We recruited 435 patients, 339 of whom were on HD at enrollment. One hundred eighty-two patients were followed for more than 24 months. Among them, 44 were switched to OL-HDF for more than 12 months without conversion to HD. We used a paired t test to compare baseline and 24-month follow-up results. Results: The mean age of the subjects was 61.2 ± 12.2 years, and 62.6% were male. The baseline hemoglobin level was not significantly different between HD and OL-HDF group (10.61 ± 1.15 vs. 10.46 ± 1.03 g/dL, P = 0.437). However, the baseline serum protein and albumin levels were significantly lower in the OL-HDF group (6.82 ± 0.49 vs. 6.59 ± 0.48 g/dL, P = 0.006; 3.93 ± 0.28 vs. 3.73 ± 0.29 g/dL, P < 0.001). In patients switched to OL-HDF, levels of hemoglobin and serum albumin significantly increased (10.46 ± 1.03 vs. 11.08 ± 0.82 g/dL, P = 0.001; 3.73 ± 0.29 vs. 3.87 ± 0.30 g/dL, P = 0.001). The normalized protein catabolic rate decreased after 24 months, but the change was not significant (1.07 ± 0.25 vs. 1.03 ± 0.21 g/kg/day, P = 0.433). Although the dose of erythropoiesis-stimulating agent was lower in patients who converted to HDF, it was not significantly different (-115.7 ± 189.7 vs.-170.5 ± 257.1 P = 0.206). Conclusion: OL-HDF treatment over more than 12 months was associated with no harmful effects on anemia and nutritional status.

Original language	English
Pages (from-to)	103-111
Number of pages	9
Journal	Kidney Research and Clinical Practice
Volume	39
Issue number	1
DOIs	https://doi.org/10.23876/j.krcp.19.082
Publication status	Published - 2020

Keywords

Anemia
Chronic
Dialysis
Hemodiafiltration
Kidney failure
Nutritional status

ASJC Scopus subject areas

Nephrology
Urology

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10.23876/j.krcp.19.082

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Lee, Y. H., Shin, Y. S., Lee, S. Y., Kim, Y. G., Lee, S. H., Moon, J. Y., Jeong, K. H., Hwang, H. S., Ahn, S. Y., Lee, H. J., Lee, D. Y., Ko, E. J., Cho, H. J., Yang, D. H., & Jeong, H. Y. (2020). Effects of online hemodiafiltration on anemia and nutritional status in chronic hemodialysis patients. Kidney Research and Clinical Practice, 39(1), 103-111. https://doi.org/10.23876/j.krcp.19.082

@article{1c8f0f7eb73c43278b1265c730190859,

title = "Effects of online hemodiafiltration on anemia and nutritional status in chronic hemodialysis patients",

abstract = "Background: Online hemodiafiltration (OL-HDF) offers considerable advantages in clearance of molecules of various sizes. However, evidence of clinical effects of OL-HDF is scarce in Korea. In this study, we investigated changes in laboratory values over more than 12 months after switching to OL-HDF. Methods: Adult patients with end-stage renal disease undergoing hemodialysis (HD) were prospectively enrolled in a K-cohort (CRIS no. KCT0003281) from 6 tertiary hospitals in South Korea. We recruited 435 patients, 339 of whom were on HD at enrollment. One hundred eighty-two patients were followed for more than 24 months. Among them, 44 were switched to OL-HDF for more than 12 months without conversion to HD. We used a paired t test to compare baseline and 24-month follow-up results. Results: The mean age of the subjects was 61.2 ± 12.2 years, and 62.6% were male. The baseline hemoglobin level was not significantly different between HD and OL-HDF group (10.61 ± 1.15 vs. 10.46 ± 1.03 g/dL, P = 0.437). However, the baseline serum protein and albumin levels were significantly lower in the OL-HDF group (6.82 ± 0.49 vs. 6.59 ± 0.48 g/dL, P = 0.006; 3.93 ± 0.28 vs. 3.73 ± 0.29 g/dL, P < 0.001). In patients switched to OL-HDF, levels of hemoglobin and serum albumin significantly increased (10.46 ± 1.03 vs. 11.08 ± 0.82 g/dL, P = 0.001; 3.73 ± 0.29 vs. 3.87 ± 0.30 g/dL, P = 0.001). The normalized protein catabolic rate decreased after 24 months, but the change was not significant (1.07 ± 0.25 vs. 1.03 ± 0.21 g/kg/day, P = 0.433). Although the dose of erythropoiesis-stimulating agent was lower in patients who converted to HDF, it was not significantly different (-115.7 ± 189.7 vs.-170.5 ± 257.1 P = 0.206). Conclusion: OL-HDF treatment over more than 12 months was associated with no harmful effects on anemia and nutritional status.",

keywords = "Anemia, Chronic, Dialysis, Hemodiafiltration, Kidney failure, Nutritional status",

author = "Lee, {Yu Ho} and Shin, {Yoon Soo} and Lee, {So Young} and Kim, {Yang Gyun} and Lee, {Sang Ho} and Moon, {Ju Young} and Jeong, {Kyung Hwan} and Hwang, {Hyeon Seok} and Ahn, {Shin Young} and Lee, {Hong Joo} and Lee, {Dong Young} and Ko, {Eun Jung} and Cho, {Hye Jeong} and Yang, {Dong Ho} and Jeong, {Hye Yun}",

note = "Funding Information: This study was supported by the Young Investigator Research Grant from the Korean Society of Nephrology (KSN 2018). Publisher Copyright: {\textcopyright} 2020 by The Korean Society of Nephrology.",

year = "2020",

doi = "10.23876/j.krcp.19.082",

language = "English",

volume = "39",

pages = "103--111",

journal = "Kidney Research and Clinical Practice",

issn = "2211-9132",

publisher = "Elsevier Korea",

number = "1",

}

TY - JOUR

T1 - Effects of online hemodiafiltration on anemia and nutritional status in chronic hemodialysis patients

AU - Lee, Yu Ho

AU - Shin, Yoon Soo

AU - Lee, So Young

AU - Kim, Yang Gyun

AU - Lee, Sang Ho

AU - Moon, Ju Young

AU - Jeong, Kyung Hwan

AU - Hwang, Hyeon Seok

AU - Ahn, Shin Young

AU - Lee, Hong Joo

AU - Lee, Dong Young

AU - Ko, Eun Jung

AU - Cho, Hye Jeong

AU - Yang, Dong Ho

AU - Jeong, Hye Yun

N1 - Funding Information: This study was supported by the Young Investigator Research Grant from the Korean Society of Nephrology (KSN 2018). Publisher Copyright: © 2020 by The Korean Society of Nephrology.

PY - 2020

Y1 - 2020

N2 - Background: Online hemodiafiltration (OL-HDF) offers considerable advantages in clearance of molecules of various sizes. However, evidence of clinical effects of OL-HDF is scarce in Korea. In this study, we investigated changes in laboratory values over more than 12 months after switching to OL-HDF. Methods: Adult patients with end-stage renal disease undergoing hemodialysis (HD) were prospectively enrolled in a K-cohort (CRIS no. KCT0003281) from 6 tertiary hospitals in South Korea. We recruited 435 patients, 339 of whom were on HD at enrollment. One hundred eighty-two patients were followed for more than 24 months. Among them, 44 were switched to OL-HDF for more than 12 months without conversion to HD. We used a paired t test to compare baseline and 24-month follow-up results. Results: The mean age of the subjects was 61.2 ± 12.2 years, and 62.6% were male. The baseline hemoglobin level was not significantly different between HD and OL-HDF group (10.61 ± 1.15 vs. 10.46 ± 1.03 g/dL, P = 0.437). However, the baseline serum protein and albumin levels were significantly lower in the OL-HDF group (6.82 ± 0.49 vs. 6.59 ± 0.48 g/dL, P = 0.006; 3.93 ± 0.28 vs. 3.73 ± 0.29 g/dL, P < 0.001). In patients switched to OL-HDF, levels of hemoglobin and serum albumin significantly increased (10.46 ± 1.03 vs. 11.08 ± 0.82 g/dL, P = 0.001; 3.73 ± 0.29 vs. 3.87 ± 0.30 g/dL, P = 0.001). The normalized protein catabolic rate decreased after 24 months, but the change was not significant (1.07 ± 0.25 vs. 1.03 ± 0.21 g/kg/day, P = 0.433). Although the dose of erythropoiesis-stimulating agent was lower in patients who converted to HDF, it was not significantly different (-115.7 ± 189.7 vs.-170.5 ± 257.1 P = 0.206). Conclusion: OL-HDF treatment over more than 12 months was associated with no harmful effects on anemia and nutritional status.

AB - Background: Online hemodiafiltration (OL-HDF) offers considerable advantages in clearance of molecules of various sizes. However, evidence of clinical effects of OL-HDF is scarce in Korea. In this study, we investigated changes in laboratory values over more than 12 months after switching to OL-HDF. Methods: Adult patients with end-stage renal disease undergoing hemodialysis (HD) were prospectively enrolled in a K-cohort (CRIS no. KCT0003281) from 6 tertiary hospitals in South Korea. We recruited 435 patients, 339 of whom were on HD at enrollment. One hundred eighty-two patients were followed for more than 24 months. Among them, 44 were switched to OL-HDF for more than 12 months without conversion to HD. We used a paired t test to compare baseline and 24-month follow-up results. Results: The mean age of the subjects was 61.2 ± 12.2 years, and 62.6% were male. The baseline hemoglobin level was not significantly different between HD and OL-HDF group (10.61 ± 1.15 vs. 10.46 ± 1.03 g/dL, P = 0.437). However, the baseline serum protein and albumin levels were significantly lower in the OL-HDF group (6.82 ± 0.49 vs. 6.59 ± 0.48 g/dL, P = 0.006; 3.93 ± 0.28 vs. 3.73 ± 0.29 g/dL, P < 0.001). In patients switched to OL-HDF, levels of hemoglobin and serum albumin significantly increased (10.46 ± 1.03 vs. 11.08 ± 0.82 g/dL, P = 0.001; 3.73 ± 0.29 vs. 3.87 ± 0.30 g/dL, P = 0.001). The normalized protein catabolic rate decreased after 24 months, but the change was not significant (1.07 ± 0.25 vs. 1.03 ± 0.21 g/kg/day, P = 0.433). Although the dose of erythropoiesis-stimulating agent was lower in patients who converted to HDF, it was not significantly different (-115.7 ± 189.7 vs.-170.5 ± 257.1 P = 0.206). Conclusion: OL-HDF treatment over more than 12 months was associated with no harmful effects on anemia and nutritional status.

KW - Anemia

KW - Chronic

KW - Dialysis

KW - Hemodiafiltration

KW - Kidney failure

KW - Nutritional status

UR - http://www.scopus.com/inward/record.url?scp=85083011244&partnerID=8YFLogxK

U2 - 10.23876/j.krcp.19.082

DO - 10.23876/j.krcp.19.082

M3 - Article

AN - SCOPUS:85083011244

SN - 2211-9132

VL - 39

SP - 103

EP - 111

JO - Kidney Research and Clinical Practice

JF - Kidney Research and Clinical Practice

IS - 1

ER -

Effects of online hemodiafiltration on anemia and nutritional status in chronic hemodialysis patients

Abstract

Keywords

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