The probability of receiving a kidney transplantation in end-stage kidney disease patients who are treated with haemodiafiltration or haemodialysis : a pooled individual participant data from four randomised controlled trials
Vernooij, Robin W. M. (Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands)
Law, Way (Department of medicine, Queen Elizabeth Hospital. Wai-ping Law, Renal unit)
Peters, Sanne A. E. (University of New South Wales. The George Institute for Global Health)
Canaud, Bernard (School of Medicine. Montpellier University)
Davenport, Andrew (Royal Free Hospital. University College London, Centre for Nephrology)
Grooteman, Muriel P. C. (Amsterdam UMC. University Medical Center)
Kircelli, Fatih (Ege University School of Medicine. Division of Nephrology)
Locatelli, Francesco (Alessandro Manzoni Hospital, past director. Department of Nephrology)
Maduell, Francisco (Hospital Clínic i Provincial de Barcelona)
Morena, Marion (University Hospital of Montpellier (França))
Nubé, Menso J. (Amsterdam UMC. University Medical Center)
Ok, Ercan (Ege University School of Medicine. Division of Nephrology)
Torres, Ferran (Universitat Autònoma de Barcelona. Departament de Pediatria, Obstetrícia i Ginecologia i Medicina Preventiva i Salut Pública)
Woodward, Mark (Johns Hopkins University. Department of Epidemiology)
Blankestijn, Peter J. (University Medical Center Utrecht. Department of Nephrology and Hypertension)
Bots, Michiel L. (Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands)

Data:	2021
Resum:	Due to a critical shortage of available kidney grafts, most patients with Stage 5 Chronic Kidney Disease (CKD5) require bridging dialysis support. It remains unclear whether treatment by different dialysis modalities changes the selection and/or preparation of a potential transplant candidate. Therefore, we assessed whether the likelihood of receiving kidney transplant (both living or deceased kidney donors) differs between haemodialysis (HD) and online haemodiafiltration (HDF) in patients with CKD5D. Individual participant data from four randomised controlled trials comparing online HDF with HD were used. Information on kidney transplant was obtained during follow-up. The likelihood of receiving a kidney transplant was compared between HD and HDF, and evaluated across different subgroups: age, sex, diabetes, history of cardiovascular disease, albumin, dialysis vintage, fistula, and level of convection volume standardized to body surface area. Hazard ratios (HRs), with corresponding 95% confidence intervals (95% CI), comparing the effect of online HDF versus HD on the likelihood of receiving a kidney transplant, were estimated using Cox proportional hazards models with a random effect for study. After a median follow-up of 2. 5 years (Q1 to Q3: 1. 9-3. 0), 331 of the 1620 (20. 4%) patients with CKD5D received a kidney transplant. This concerned 22% (n = 179) of patients who were treated with online HDF compared with 19% (n = 152) of patients who were treated with HD. No differences in the likelihood of undergoing a kidney transplant were found between the two dialysis modalities in both the crude analyse (HR: 1. 07, 95% CI: 0. 86-1. 33) and adjusted analysis for age, sex, diabetes, cardiovascular history, albumin, and creatinine (HR: 1. 15, 95%-CI: 0. 92-1. 44). There was no evidence for a differential effect across subgroups based on patient- and disease-characteristics nor in different categories of convection volumes. Treatment with HD and HDF does not affect the selection and/or preparation of CKD5D patients for kidney transplant given that the likelihood of receiving a kidney transplant does not differ between the dialysis modalities. These finding persisted across a variety of subgroups differing in patient and disease characteristics and is not affected by the level of convection volume delivered during HDF treatment sessions.
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Llengua:	Anglès
Document:	Article ; recerca ; Versió publicada
Publicat a:	BMC Nephrology, Vol. 22 (february 2021) , ISSN 1471-2369

DOI: 10.1186/s12882-021-02265-6
PMID: 33632160

9 p, 322.4 KB

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