Author(s):
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Hoedt, C.H. den; Bots, M.L.; Grooteman, M.P.; Weerd, N.C. van der; Mazairac, A.H.; Penne, E.L.; Levesque, R.; Wee, P.M. ter; Nube, M.J.; Blankestijn, P.J.; Dorpel, M.A. van den;
Hamersvelt, H.W. van
; et al.
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Subject:
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Radboudumc 0: Other Research RIHS: Radboud Institute for Health Sciences |
Journal title:
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Kidney International. Supplement
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Abstract:
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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.
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