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2. Frequent hemodialysis versus standard hemodialysis for people with kidney failure: Systematic review and meta-analysis of randomized controlled trials.

Author

Natale, Patrizia, Green, Suetonia C., Rose, Matthias, Bots, Michiel L., Blankestijn, Peter J., Vernooij, Robin W. M., Gerittsen, Karin, Woodward, Mark, Hockham, Carinna, Cromm, Krister, Barth, Claudia, Davenport, Andrew, Hegbrant, Jörgen, Sarafidis, Pantelis, Das, Partha, Wanner, Christoph, Nissenson, Allan R., Sautenet, Benedicte, Török, Marietta, and Strippoli, Giovanni

Subjects
RANDOMIZED controlled trials, QUALITY of life, KIDNEY failure, ARTERIAL catheterization, PATIENT reported outcome measures
Abstract

Background: Frequent hemodialysis provided more than three times per week may lower mortality and improve health-related quality of life. Yet, the evidence is inconclusive. We evaluated the benefits and harms of frequent hemodialysis in people with kidney failure compared with standard hemodialysis. Methods: We performed a systematic review of randomized controlled trials including adults on hemodialysis with highly sensitive searching in MEDLINE, Embase, CENTRAL, and Google Scholar on 3 January 2024. Data were pooled using random-effects meta-analysis. Risk of bias was assessed using the Cochrane Risk of Bias 2 tool. We adjudicated evidence certainty using GRADE. Results: From 11,142 unique citations, only seven studies involving 518 participants proved eligible. The effects of frequent hemodialysis on physical and mental health were imprecise due to few data. Frequent hemodialysis probably had uncertain effect on death from all cause compared with standard hemodialysis (relative risk 0.79, 95% confidence interval 0.33–1.91, low certainty evidence). Data were not reported for death from cardiovascular causes, major cardiovascular events, fatigue or vascular access. Conclusion: The evidentiary basis for frequent hemodialysis is incomplete due to clinical trials with few or no events reported for mortality and cardiovascular outcome measures and few participants in which patient-reported outcomes including health-related quality of life and symptoms were reported. [ABSTRACT FROM AUTHOR]

Published
2024
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4. Frequent hemodialysis versus standard hemodialysis for people with kidney failure: Systematic review and meta-analysis of randomized controlled trials

Author

Cardiovasculaire Epi Team 5, Cardiovasculaire Epidemiologie, Circulatory Health, JC onderzoeksprogramma Cardiovascular Health, Nefro Vasculaire Geneeskunde, MS Nefrologie, Regenerative Medicine and Stem Cells, Natale, Patrizia, Green, Suetonia C, Rose, Matthias, Bots, Michiel L, Blankestijn, Peter J, Vernooij, Robin W M, Gerittsen, Karin, Woodward, Mark, Hockham, Carinna, Cromm, Krister, Barth, Claudia, Davenport, Andrew, Hegbrant, Jörgen, Sarafidis, Pantelis, Das, Partha, Wanner, Christoph, Nissenson, Allan R, Sautenet, Benedicte, Török, Marietta, Strippoli, Giovanni, Cardiovasculaire Epi Team 5, Cardiovasculaire Epidemiologie, Circulatory Health, JC onderzoeksprogramma Cardiovascular Health, Nefro Vasculaire Geneeskunde, MS Nefrologie, Regenerative Medicine and Stem Cells, Natale, Patrizia, Green, Suetonia C, Rose, Matthias, Bots, Michiel L, Blankestijn, Peter J, Vernooij, Robin W M, Gerittsen, Karin, Woodward, Mark, Hockham, Carinna, Cromm, Krister, Barth, Claudia, Davenport, Andrew, Hegbrant, Jörgen, Sarafidis, Pantelis, Das, Partha, Wanner, Christoph, Nissenson, Allan R, Sautenet, Benedicte, Török, Marietta, and Strippoli, Giovanni

Published
2024

5. Physical performance tasks were linked to the PROMIS physical function metric in patients undergoing hemodialysis

Author

Cardiovasculaire Epi Team 5, Cardiovasculaire Epidemiologie, Circulatory Health, JC onderzoeksprogramma Cardiovascular Health, Nefro Vasculaire Geneeskunde, Liegl, Gregor, Fischer, Felix H, Woodward, Mark, Török, Marietta, Strippoli, Giovanni F M, Hegbrant, Jörgen, Davenport, Andrew, Cromm, Krister, Canaud, Bernard, Bots, Michiel L, Blankestijn, Peter J, Barth, Claudia, Fischer, Kathrin I, Rose, Matthias, Cardiovasculaire Epi Team 5, Cardiovasculaire Epidemiologie, Circulatory Health, JC onderzoeksprogramma Cardiovascular Health, Nefro Vasculaire Geneeskunde, Liegl, Gregor, Fischer, Felix H, Woodward, Mark, Török, Marietta, Strippoli, Giovanni F M, Hegbrant, Jörgen, Davenport, Andrew, Cromm, Krister, Canaud, Bernard, Bots, Michiel L, Blankestijn, Peter J, Barth, Claudia, Fischer, Kathrin I, and Rose, Matthias

Published
2023

8. Dietary Potassium Intake and All-Cause Mortality in Adults Treated with Hemodialysis

Author

Bernier-Jean, Amelie, primary, Wong, Germaine, additional, Saglimbene, Valeria, additional, Ruospo, Marinella, additional, Palmer, Suetonia C., additional, Natale, Patrizia, additional, Garcia-Larsen, Vanessa, additional, Johnson, David W., additional, Tonelli, Marcello, additional, Hegbrant, Jörgen, additional, Craig, Jonathan C., additional, Teixeira-Pinto, Armando, additional, and Strippoli, Giovanni F.M., additional

Published
2021
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11. MO812THE COMPARISON OF HIGH-DOSE HAEMODIAFILTRATION WITH HIGH-FLUX HAEMODIALYSIS (CONVINCE) STUDY: BASELINE CHARACTERISTICS AND PROOF OF PRINCIPLE OF THE CONVECTION VOLUME DELIVERED

Author

Vernooij, Robin, primary, Lee, Mei-Man, additional, Woodward, Mark, additional, Hegbrant, Jörgen, additional, Canaud, Bernard, additional, Cromm, Krister, additional, Torok, Marietta, additional, Fischer, Kathrin, additional, Barth, Claudia, additional, Strippoli, Giovanni, additional, Blankestijn, Peter J, additional, and Bots, Michiel, additional

Published
2021
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12. Benefits and harms of high-dose haemodiafiltration versus high-flux haemodialysis : the comparison of high-dose haemodiafiltration with high-flux haemodialysis (CONVINCE) trial protocol

Author

Blankestijn, Peter J, Fischer, Kathrin I, Barth, Claudia, Cromm, Krister, Canaud, Bernard, Davenport, Andrew, Grobbee, Diederick E, Hegbrant, Jörgen, Roes, Kit C, Rose, Matthias, Strippoli, Giovanni Fm, Vernooij, Robin Wm, Woodward, Mark, de Wit, G Ardine, Bots, Michiel L, Blankestijn, Peter J, Fischer, Kathrin I, Barth, Claudia, Cromm, Krister, Canaud, Bernard, Davenport, Andrew, Grobbee, Diederick E, Hegbrant, Jörgen, Roes, Kit C, Rose, Matthias, Strippoli, Giovanni Fm, Vernooij, Robin Wm, Woodward, Mark, de Wit, G Ardine, and Bots, Michiel L

Published
2020

13. Benefits and harms of high-dose haemodiafiltration versus high-flux haemodialysis: the comparison of high-dose haemodiafiltration with high-flux haemodialysis (CONVINCE) trial protocol

Author

MS Nefrologie, Circulatory Health, Cardiovasculaire Epi Team 9, JC onderzoeksprogramma Cardiovasculaire Epidemiologie, Biostatistiek Onderzoek, HEE Team 1, JC onderzoeksprogramma Methodologie, Cardiovasculaire Epi Team 5, Blankestijn, Peter J, Fischer, Kathrin I, Barth, Claudia, Cromm, Krister, Canaud, Bernard, Davenport, Andrew, Grobbee, Diederick E, Hegbrant, Jörgen, Roes, Kit C, Rose, Matthias, Strippoli, Giovanni Fm, Vernooij, Robin Wm, Woodward, Mark, de Wit, G Ardine, Bots, Michiel L, MS Nefrologie, Circulatory Health, Cardiovasculaire Epi Team 9, JC onderzoeksprogramma Cardiovasculaire Epidemiologie, Biostatistiek Onderzoek, HEE Team 1, JC onderzoeksprogramma Methodologie, Cardiovasculaire Epi Team 5, Blankestijn, Peter J, Fischer, Kathrin I, Barth, Claudia, Cromm, Krister, Canaud, Bernard, Davenport, Andrew, Grobbee, Diederick E, Hegbrant, Jörgen, Roes, Kit C, Rose, Matthias, Strippoli, Giovanni Fm, Vernooij, Robin Wm, Woodward, Mark, de Wit, G Ardine, and Bots, Michiel L

Published
2020

14. Online haemodiafiltration: definition, dose quantification and safety revisited

Author

Tattersall, James E., Ward, Richard A., Canaud, Bernard, Blankestijn, Peter J., Bots, Michiel, Covic, Adrian, Davenport, Andrew, Grooteman, Muriel, Gura, Victor, Hegbrant, Jörgen, Hoffmann, Joerg, Hothi, Daljit, Hutchison, Colin, Kircelli, Fatih, Krieter, Detlef, Kuhlmann, Martin, Ledebo, Ingrid, Locatelli, Francesco, Maduell, Francisco, Martin-Malo, Alejandro, Nicoud, Philippe, Nubé, Menso, Ok, Ercan, Pedrini, Luciano, Port, Friedrich, Ragon, Alain, Santoro, Antonio, Schindler, Ralf, Shroff, Rukshana, Tattersall, James, Vanholder, Raymond, and Ward, Richard

Published
2013
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17. Benefits and harms of high-dose haemodiafiltration versus high-flux haemodialysis: the comparison of high-dose haemodiafiltration with high-flux haemodialysis (CONVINCE) trial protocol

Author

Blankestijn, Peter J, primary, Fischer, Kathrin I, additional, Barth, Claudia, additional, Cromm, Krister, additional, Canaud, Bernard, additional, Davenport, Andrew, additional, Grobbee, Diederick E, additional, Hegbrant, Jörgen, additional, Roes, Kit C, additional, Rose, Matthias, additional, Strippoli, Giovanni FM, additional, Vernooij, Robin WM, additional, Woodward, Mark, additional, de Wit, G Ardine, additional, and Bots, Michiel L, additional

Published
2020
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22. FP435ORAL MUCOSAL LESIONS AND ASSOCIATION WITH MORTALITY IN HEMODIALYSIS PATIENTS: A PROSPECTIVE COHORT ANALYSIS (ORAL-D SUBSTUDY)

Author

Ruospo, Marinella, primary, Palmer, Suetonia, additional, Graziano, Giusi, additional, Natale, Patrizia, additional, Saglimbene, Valeria, additional, Craig, Jonathan, additional, Johnson, David W, additional, Tonelli, Marcello, additional, Celia, Eduardo, additional, Gelfman, Rubén, additional, Duława, Jua, additional, Bednarek-Skublewska, Anna, additional, Török, Marietta, additional, Stroumza, Paul, additional, Del, Castillo, Domingo, additional, Bernat, Amparo, additional, Hegbrant, Jörgen, additional, Wollheim, Charlotta, additional, Gargano, Letizia, additional, and Strippoli, Giovanni, additional

Published
2019
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24. FP674ORAL SYMPTOMS AND SALIVARY FUNCTION AND ASSOCIATION WITH MORTALITY IN HAEMODIALYSIS PATIENTS: A PROSPECTIVE COHORT ANALYSIS (ORAL-D SUBSTUDY)

Author

Ruospo, Marinella, primary, Palmer, Suetonia, additional, Graziano, Giusi, additional, Natale, Patrizia, additional, Saglimbene, Valeria, additional, Craig, Jonathan, additional, Johnson, David W, additional, Tonelli, Marcello, additional, Celia, Eduardo, additional, Gelfman, Rubén, additional, Jan, Dulawa, additional, Bednarek-Skublewska, Anna, additional, Török, Marietta, additional, Stroumza, Paul, additional, Del, Castillo, Domingo, additional, Bernat, Amparo, additional, Hegbrant, Jörgen, additional, Wollheim, Charlotta, additional, Gargano, Letizia, additional, and Strippoli, Giovanni, additional

Published
2019
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26. Fruit and Vegetable Intake and Mortality in Adults undergoing Maintenance Hemodialysis

Author

Saglimbene, Valeria M., primary, Wong, Germaine, additional, Ruospo, Marinella, additional, Palmer, Suetonia C., additional, Garcia-Larsen, Vanessa, additional, Natale, Patrizia, additional, Teixeira-Pinto, Armando, additional, Campbell, Katrina L., additional, Carrero, Juan-Jesus, additional, Stenvinkel, Peter, additional, Gargano, Letizia, additional, Murgo, Angelo M., additional, Johnson, David W., additional, Tonelli, Marcello, additional, Gelfman, Rubén, additional, Celia, Eduardo, additional, Ecder, Tevfik, additional, Bernat, Amparo G., additional, Del Castillo, Domingo, additional, Timofte, Delia, additional, Török, Marietta, additional, Bednarek-Skublewska, Anna, additional, Duława, Jan, additional, Stroumza, Paul, additional, Hoischen, Susanne, additional, Hansis, Martin, additional, Fabricius, Elisabeth, additional, Felaco, Paolo, additional, Wollheim, Charlotta, additional, Hegbrant, Jörgen, additional, Craig, Jonathan C., additional, and Strippoli, Giovanni F.M., additional

Published
2019
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27. Person-Centered Integrated Care for Chronic Kidney Disease: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

Author

Valentijn, Pim P, Pereira, Fernando Abdalla, Ruospo, Marinella, Palmer, Suetonia C, Hegbrant, Jörgen, Sterner, Christina W, Vrijhoef, Hubertus J M, Ruwaard, Dirk, Strippoli, Giovanni F M, Valentijn, Pim P, Pereira, Fernando Abdalla, Ruospo, Marinella, Palmer, Suetonia C, Hegbrant, Jörgen, Sterner, Christina W, Vrijhoef, Hubertus J M, Ruwaard, Dirk, and Strippoli, Giovanni F M

Abstract

BACKGROUND AND OBJECTIVES: The effectiveness of person-centered integrated care strategies for CKD is uncertain. We conducted a systematic review and meta-analysis of randomized, controlled trials to assess the effect of person-centered integrated care for CKD.DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: We searched MEDLINE, Embase, and Cochrane Central Register of Controlled Trials (from inception to April of 2016), and selected randomized, controlled trials of person-centered integrated care interventions with a minimum follow-up of 3 months. Random-effects meta-analysis was used to assess the effect of person-centered integrated care.RESULTS: We included 14 eligible studies covering 4693 participants with a mean follow-up of 12 months. In moderate quality evidence, person-centered integrated care probably had no effect on all-cause mortality (relative risk [RR], 0.86; 95% confidence interval [95% CI], 0.68 to 1.08) or health-related quality of life (standardized mean difference, 0.02; 95% CI, -0.05 to 0.10). The effects on renal replacement therapy (RRT) (RR, 1.00; 95% CI, 0.65 to 1.55), serum creatinine levels (mean difference, 0.59 mg/dl; 95% CI, -0.38 to 0.36), and eGFR (mean difference, 1.51 ml/min per 1.73 m2; 95% CI, -3.25 to 6.27) were very uncertain. Quantitative analysis suggested that person-centered integrated care interventions may reduce all-cause hospitalization (RR, 0.38; 95% CI, 0.15 to 0.95) and improve BP control (RR, 1.20; 95% CI, 1.00 to 1.44), although the certainty of the evidence was very low.CONCLUSIONS: Person-centered integrated care may have little effect on mortality or quality of life. The effects on serum creatinine, eGFR, and RRT are uncertain, although person-centered integrated care may lead to fewer hospitalizations and improved BP control.

Published
2018

28. FP630ASSOCIATION OF FRUIT AND VEGETABLE INTAKE WITH ALL-CAUSE MORTALITY IN HEMODIALYSIS PATIENTS (DIET-HD): A PROSPECTIVE COHORT STUDY

Author

Saglimbene, Valeria, primary, Wong, Germaine, additional, Ruospo, Marinella, additional, Palmer, Suetonia, additional, Natale, Patrizia, additional, Garcia-Larsen, Vanessa, additional, Campbell, Katrina, additional, Carrero, Juan-Jesus, additional, Stenvinkel, Peter, additional, Gargano, Letizia, additional, Murgo, Angelo, additional, Gelfman, Rubén, additional, Bernat, Amparo, additional, Del Castillo, Domingo, additional, Timofte, Delia, additional, Török, Marietta, additional, Bednarek-Skublewska, Anna, additional, Duława, Jan, additional, Stroumza, Paul, additional, Hansis, Martin, additional, Fabricius, Elisabeth, additional, Wollheim, Charlotta, additional, Hegbrant, Jörgen, additional, Craig, Jonathan, additional, and Strippoli on behalf of the DIET-HD investigators, Giovanni, additional

Published
2018
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29. FP662THE ASSOCIATION OF MEDITERRANEAN AND DASH DIETS WITH MORTALITY IN ADULTS ON HEMODIALYSIS: THE DIET-HD MULTINATIONAL COHORT STUDY

Author

Saglimbene, Valeria, primary, Wong, Germaine, additional, Ruospo, Marinella, additional, Palmer, Suetonia, additional, Natale, Patrizia, additional, Campbell, Katrina, additional, Garcia-Larsen, Vanessa, additional, Carrero, Juan-Jesus, additional, Stenvinkel, Peter, additional, Gargano, Letizia, additional, Murgo, Angelo, additional, Gelfman, Rubén, additional, Bernat, Amparo, additional, Del Castillo, Domingo, additional, Timofte, Delia, additional, Török, Marietta, additional, Bednarek-Skublewska, Anna, additional, Duława, Jan, additional, Stroumza, Paul, additional, Hansis, Martin, additional, Fabricius, Elisabeth, additional, Wollheim, Charlotta, additional, Hegbrant, Jörgen, additional, Craig, Jonathan, additional, and Strippoli on behalf of the DIET-HD investigators, Giovanni, additional

Published
2018
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30. The Association of Mediterranean and DASH Diets with Mortality in Adults on Hemodialysis: The DIET-HD Multinational Cohort Study

Author

Saglimbene, Valeria M., primary, Wong, Germaine, additional, Craig, Jonathan C., additional, Ruospo, Marinella, additional, Palmer, Suetonia C., additional, Campbell, Katrina, additional, Garcia-Larsen, Vanessa, additional, Natale, Patrizia, additional, Teixeira-Pinto, Armando, additional, Carrero, Juan-Jesus, additional, Stenvinkel, Peter, additional, Gargano, Letizia, additional, Murgo, Angelo M., additional, Johnson, David W., additional, Tonelli, Marcello, additional, Gelfman, Rubén, additional, Celia, Eduardo, additional, Ecder, Tevfik, additional, Bernat, Amparo G., additional, Del Castillo, Domingo, additional, Timofte, Delia, additional, Török, Marietta, additional, Bednarek-Skublewska, Anna, additional, Duława, Jan, additional, Stroumza, Paul, additional, Hoischen, Susanne, additional, Hansis, Martin, additional, Fabricius, Elisabeth, additional, Felaco, Paolo, additional, Wollheim, Charlotta, additional, Hegbrant, Jörgen, additional, and Strippoli, Giovanni F.M., additional

Published
2018
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31. Person-Centered Integrated Care for Chronic Kidney Disease

Author

Valentijn, Pim P., primary, Pereira, Fernando Abdalla, additional, Ruospo, Marinella, additional, Palmer, Suetonia C., additional, Hegbrant, Jörgen, additional, Sterner, Christina W., additional, Vrijhoef, Hubertus J.M., additional, Ruwaard, Dirk, additional, and Strippoli, Giovanni F.M., additional

Published
2018
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32. The prevalence and correlates of low sexual functioning in women on hemodialysis: A multinational, cross-sectional study

Author

Saglimbene, Valeria, primary, Natale, Patrizia, additional, Palmer, Suetonia, additional, Scardapane, Marco, additional, Craig, Jonathan C., additional, Ruospo, Marinella, additional, Gargano, Letizia, additional, Lucisano, Giuseppe, additional, Török, Marietta, additional, Celia, Eduardo, additional, Gelfman, Rubén, additional, Bednarek-Skublewska, Anna, additional, Dulawa, Jan, additional, Stroumza, Paul, additional, Leal, Miguel, additional, Del Castillo, Domingo, additional, Murgo, Angelo Marco, additional, Schon, Staffan, additional, Wollheim, Charlotta, additional, Hegbrant, Jörgen, additional, and Strippoli, Giovanni F. M., additional

Published
2017
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33. MP545PERITONEAL DIALYSIS ANNUAL DROP OUT IN A LARGE INTERNATIONAL SETTING

Author

Marrón, Belén, primary, Moretta, Gustavo, additional, Roesch, Michael, additional, Ostrowski, Janusz, additional, Török, Marietta, additional, Pérez, Daniel, additional, Timofte, Delia, additional, Castillo, Luis, additional, Stroumza, Paul, additional, Fabricius, Elisabeth, additional, and Hegbrant, Jörgen, additional

Published
2017
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35. SP502PERITONEAL DIALYSIS ANNUAL DROP OUT MONITORING INCREASES PATIENT AND TECHNIQUE SURVIVAL

Author

Marrón, Belén, primary, Timofte, Delia, additional, Roesch, Michael, additional, Ostrowski, Janusz, additional, Török, Marietta, additional, Dillman, Andreas, additional, Kochman, Pawel, additional, Orosz, Attila, additional, Moretta, Gustavo, additional, Pérez, Daniel, additional, Castillo, Luis, additional, Stroumza, Paul, additional, Fabricius, Elisabeth, additional, Munier, Alexandra, additional, and Hegbrant, Jörgen, additional

Published
2017
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36. SP607THE PREVALENCE AND CORRELATES OF SEXUAL DYSFUNCTION IN WOMEN ON HEMODIALYSIS: A MULTINATIONAL, CROSS-SECTIONAL STUDY

Author

Saglimbene, Valeria, primary, Palmer, Suetonia, additional, Natale, Patrizia, additional, Scardapane, Marco, additional, Ruospo, Marinella, additional, Craig, Jonathan, additional, Gargano, Letizia, additional, Lucisano, Giuseppe, additional, Török, Marietta, additional, Celia, Eduardo, additional, Gelfman, Ruben, additional, Bednarek Skublewska, Anna, additional, Dulawa, Jan, additional, Stroumza, Paul, additional, Leal, Miguel, additional, Murgo, Angelo, additional, Schon, Staffan, additional, Wollheim, Charlotta, additional, Hegbrant, Jörgen, additional, and Strippoli, Giovanni, additional

Published
2016
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38. Depression and all-cause and cardiovascular mortality in patients on haemodialysis: a multinational cohort study

Author

Saglimbene, Valeria, primary, Palmer, Suetonia, additional, Scardapane, Marco, additional, Craig, Jonathan C., additional, Ruospo, Marinella, additional, Natale, Patrizia, additional, Gargano, Letizia, additional, Leal, Miguel, additional, Bednarek-Skublewska, Anna, additional, Dulawa, Jan, additional, Ecder, Tevfik, additional, Stroumza, Paul, additional, Marco Murgo, Angelo, additional, Schön, Staffan, additional, Wollheim, Charlotta, additional, Hegbrant, Jörgen, additional, and Strippoli, Giovanni F.M., additional

Published
2016
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39. COGNITIVE-HD study: protocol of an observational study of neurocognitive functioning and association with clinical outcomes in adults with end-stage kidney disease treated with haemodialysis

Author

Palmer, Suetonia C, primary, Ruospo, Marinella, additional, Barulli, Maria Rosaria, additional, Iurillo, Annalisa, additional, Saglimbene, Valeria, additional, Natale, Patrizia, additional, Gargano, Letizia, additional, Murgo, Angelo M, additional, Loy, Clement, additional, van Zwieten, Anita, additional, Wong, Germaine, additional, Tortelli, Rosanna, additional, Craig, Jonathan C, additional, Johnson, David W, additional, Tonelli, Marcello, additional, Hegbrant, Jörgen, additional, Wollheim, Charlotta, additional, Logroscino, Giancarlo, additional, and Strippoli, G F M, additional

Published
2015
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41. Low versus high dose erythropoiesis-stimulating agents in hemodialysis patients with anemia: A randomized clinical trial.

Author

Saglimbene, Valeria, Palmer, Suetonia C., Craig, Jonathan C., Ruospo, Marinella, Nicolucci, Antonio, Tonelli, Marcello, Johnson, David, Lucisano, Giuseppe, Williams, Gabrielle, Valentini, Miriam, D’Alonzo, Daniela, Pellegrini, Fabio, Strippoli, Paolo, Salomone, Mario, Santoro, Antonio, Maffei, Stefano, Hegbrant, Jörgen, Tognoni, Gianni, Strippoli, Giovanni F. M., and null, null

Subjects
ANEMIA treatment, HEMODIALYSIS, ERYTHROPOIESIS, HEMOGLOBINS, ADVERSE health care events, RANDOMIZED controlled trials
Abstract

The increased risks of death and adverse events with erythropoiesis-stimulating agent (ESA) therapy targeting a higher hemoglobin level are established. It is uncertain whether the adverse effects of ESA therapy are related to dose and are mitigated when a fixed low ESA dose is used. We conducted a multicenter, prospective randomized open-label, blinded-endpoint (PROBE) trial to evaluate fixed low versus high dose ESA therapy on patient outcomes. We intended to recruit 2104 hemodialysis patients >18 years with anemia or receiving ESA treated at dialysis clinics in Italy. The intervention was fixed low (4000 IU epoetin alfa equivalent weekly) or high (18,000 IU epoetin alfa equivalent weekly) dose ESA for 12 months. Primary outcomes were serum transferrin, ferritin, albumin, C-reactive protein and ESA dose. Secondary outcomes were the composite of death or cardiovascular event, all-cause mortality, cardiovascular mortality, myocardial infarction, stroke, cardiovascular hospitalization, and quality of life. Study recruitment was terminated after inclusion of 656 participants with convergence of ESA dose between groups during follow up. Fixed low dose ESA had uncertain effects on serum ferritin (delta of delta (DD) 3.9 ng/ml, 95% CI -85.0 to 92.8), transferrin (9.2 mg/dl, -6.3 to 24.8), transferrin saturation (3.7%, -5.0 to 12.3), serum albumin (-0.03 g/dl, -0.2 to 0.1), or C-reactive protein (-0.6 mg/l, -3.3 to 2.1). In addition, fixed dose therapy had inconclusive effects on the composite endpoint of mortality and cardiovascular events (hazard ratio [HR] 0.95, 95% CI 0.66 to 1.37), death (0.98, 0.64 to 1.52), nonfatal myocardial infarction (0.52, 0.18 to 1.52), nonfatal stroke (no events), hospital admission for cardiovascular causes (0.93, 0.50 to 1.72) or health-related quality of life. A fixed low ESA dose in hemodialysis patients has uncertain effects on serum parameters, mortality, cardiovascular events, and quality of life. Hemoglobin targets may be so entrenched in nephrology practice that a trial of ESA dose is no longer possible. [ABSTRACT FROM AUTHOR]

Published
2017
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42. Patient satisfaction with in-centre haemodialysis care: an international survey

Author

Palmer, Suetonia C, primary, de Berardis, Giorgia, additional, Craig, Jonathan C, additional, Tong, Allison, additional, Tonelli, Marcello, additional, Pellegrini, Fabio, additional, Ruospo, Marinella, additional, Hegbrant, Jörgen, additional, Wollheim, Charlotta, additional, Celia, Eduardo, additional, Gelfman, Ruben, additional, Ferrari, Juan Nin, additional, Törok, Marietta, additional, Murgo, Marco, additional, Leal, Miguel, additional, Bednarek-Skublewska, Anna, additional, Dulawa, Jan, additional, and Strippoli, Giovanni F M, additional

Published
2014
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44. A theoretical investigation of the supersaturation of basic calcium phosphate in serum of dialysis patients

Author

Sandin, Karin, Hegbrant, Jörgen, Kloo, Lars A., Olsson, Lars -Fride, Sandin, Karin, Hegbrant, Jörgen, Kloo, Lars A., and Olsson, Lars -Fride

Abstract

Extraosseous calcification in hemodialysis (HD) patients consists mainly of biological apatite, idealized as hydroxyapatite. Other suggested calcium phosphates are octacalcium phosphate (OCP) and brushite, both known to be hydroxyapatite precursors. Whatever the mechanisms of mineral deposition are, these mechanisms are always required to produce a supersaturated state, and that state can be calculated from the solubility product (SP) of the relevant mineral. Supersaturation in relation to serum ionized calcium [Ca2+] and total inorganic serum phosphate (Pi) under normal and hyperphosphatemic conditions has been calculated. While supersaturation with respect to hydroxyapatite and OCP always exists, and supersaturation with respect to Ca5(PO4)3(HCO3)·4H2O is just above the limit, supersaturation with respect to brushite solely occurs under hyperphosphatemic conditions. In order to avoid supersaturation with respect to brushite the maximum serum phosphate level allowed is 1.9 mmol/L (5.8 mg/dl) and the calcium-phosphate product (Ca x— P) 4.5 (mmol/L)2 (56 (mg/dl))2., QC 20101220

Published
2006

46. CONVINCE in the context of existing evidence on haemodiafiltration

Author

Vernooij, Robin W M, Bots, Michiel L, Strippoli, Giovanni F M, Canaud, Bernard, Cromm, Krister, Woodward, Mark, Blankestijn, Peter J, Davenport, Andrew, Barth, Claudia, Strippoli, Giovanni, Hegbrant, Jörgen, Fischer, Kathrin, Török, Mariëtta, Rose, Matthias, and Bots, Michiel

Subjects
Transplantation, integumentary system, Nephrology, Renal Dialysis, Humans, Kidney Failure, Chronic, Hemodiafiltration, Convection
Abstract

Haemodiafiltration (HDF) provides a greater removal of larger solutes and protein-bound compounds than conventional high-flux haemodialysis (HD). There are indications that the patients receiving the highest convection volumes of HDF result in improved survival compared with HD. However, the comparative efficacy of HDF versus HD remains unproven. Here we provide a comparative account of the methodology and aims of ‘the comparison of high-dose HDF with high-flux HD’ (CONVINCE) study in the context of the totality of evidence and how this study will contribute to reaching a higher level of certainty regarding the comparative efficacy of HDF versus HD in people with end-stage kidney disease.

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47. Psychosocial Determinants for Self-Reported Health Status in Hemodialysis Patients: A Cohort Analysis of the CONVINCE Randomized Trial.

Author

Cromm K, Ngoc Pham LH, Jaha H, Fischer KI, Liegl G, Schappert A, Davenport A, Barth C, Blankestijn PJ, Hegbrant J, Fischer FH, Strippoli GFM, and Rose M

Abstract

Background: We investigated whether psychosocial determinants self-efficacy and social support are associated with Health-Related Quality of Life in hemodialysis patients enrolled in the CONVINCE trial., Methods: We used baseline data from the cohort of patients involved in the CONVINCE randomized trial of hemodiafiltration versus hemodialysis. Measures included age, gender, relationship status, children, housing, education, employment, comorbidities, dialysis schedules, time of first dialysis, residual kidney function, general self-efficacy and social support scores, and PROMIS measurements for health-related quality of life. Associations were analyzed using hierarchical regression., Results: One thousand three hundred and sixty patients from CONVINCE were the cohort of interest. Mean age was 62±13.5 years (range 20-92), and 66.9% were men. Self-efficacy was a significant predictor for all health-related quality of life domains: depression (β = -0.36, p < 0.001), anxiety (β = -0.35, p < 0.001), social participation (β = 0.32, p < 0.001), cognition (β = 0.29, p < 0.001), fatigue (β = -0.29, p < 0.001), physical function (β = 0.27, p < 0.001), sleep disturbance (β = -0.23, p < 0.001), pain interference (β = 0.21, p < 0.001), pain intensity (β = -0.17, p < 0.001), interdialytic symptoms (β = -0.14, p = 0.002) and intradialytic symptoms (β = -0.14, p = 0.002). Social support was a significant predictor for cognition (β = 0.21, p < 0.001), sleep disturbance (β = -0.11, p = 0.017) and intradialytic symptoms (β =- 0.11, p = 0.02)., Conclusions: Higher general self-efficacy scale scores are associated with improvements in cognition, depression, anxiety, social participation, fatigue, physical function, sleep disturbance, pain interference, interdialytic symptoms, pain intensity and intradialytic symptoms. Associations for self-efficacy are larger than those for social support and stronger than previously reported. It is plausible that targeted psychosocial interventions may improve health outcomes in people on hemodialysis., (Copyright © 2024 The Author(s). Published by Wolters Kluwer Health, Inc. on behalf of the American Society of Nephrology.)

Published
2024
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48. Oral mucosal lesions and risk of all-cause and cardiovascular mortality in people treated with long-term haemodialysis: The ORAL-D multinational cohort study.

Author

Ruospo M, Palmer SC, Graziano G, Natale P, Saglimbene V, Petruzzi M, De Benedittis M, Craig JC, Johnson DW, Ford P, Tonelli M, Celia E, Gelfman R, Leal MR, Török M, Stroumza P, Frantzen L, Bednarek-Skublewska A, Dulawa J, Del Castillo D, Schön S, Bernat AG, Hegbrant J, Wollheim C, Gargano L, and Strippoli GFM

Subjects
Adolescent, Adult, Aged, Aged, 80 and over, Cardiovascular Diseases epidemiology, Cause of Death, Cohort Studies, Female, Humans, Internationality, Male, Middle Aged, Mouth Diseases complications, Mouth Diseases mortality, Prevalence, Renal Insufficiency, Chronic complications, Renal Insufficiency, Chronic epidemiology, Renal Insufficiency, Chronic therapy, Risk Factors, Young Adult, Cardiovascular Diseases etiology, Cardiovascular Diseases mortality, Mouth Diseases epidemiology, Renal Dialysis adverse effects, Renal Dialysis mortality, Renal Dialysis statistics & numerical data, Renal Insufficiency, Chronic mortality
Abstract

Background: Chronic kidney disease is a risk factor for oral diseases, which may be associated with premature death. We evaluated the risk of all-cause and cardiovascular mortality associated with oral mucosal lesions in adults with kidney failure treated with long-term haemodialysis., Methods: Oral mucosal lesions (herpes, ulceration, neoformation, white lesion, red lesion, oral candidiasis, geographical tongue, petechial lesions, and fissured tongue) were evaluated within the Oral Diseases in Haemodialysis (ORAL-D) study, a multinational cohort study of 4726 haemodialysis adults. We conducted cox regression analyses adjusted for demographic and clinical variables to evaluate the association with all-cause and cardiovascular mortality., Results: Overall, 4205 adults (mean age 61.6 ± 15.6 years) underwent oral mucosal examination with 40% affected by at least one lesion. The prevalence of oral lesions was (in order of frequency): oral herpes 0.5%, mucosal ulceration 1.7%, neoformation 2.0%, white lesion 3.5%, red lesion 4.0%, oral candidiasis 4.6%, geographical tongue 4.9%, petechial lesions 7.9%, and fissured tongue 10.7%. During median follow-up of 3.5 years, 2114 patients died (1013 due to cardiovascular disease). No association was observed between any individual oral lesion and all-cause or cardiovascular mortality when adjusted for comorbidities, except for oral candidiasis, which was associated with all-cause mortality (adjusted hazard ratio 1.37, 95% CI 1.00 to 1.86) and cardiovascular mortality (adjusted hazard ratio 1.64, 95% CI 1.09 to 2.46)., Conclusion: Oral mucosal lesions are prevalent in haemodialysis patients. Oral candidiasis appears to be a risk factor for death due to cardiovascular diseases., Competing Interests: MR, PN, VS, EC, RG, MRL, MT, PS, AB-S, JD, LF, JNF, DC, SS, AGB, JH, CW, LG are employees of Diaverum. GS holds a consultancy with Diaverum Renal Services. JH and GS received unrestricted funding from Diaverum Renal Services, a provider of renal services and LCO (Le Cliniche Odontoiatriche, Italy). Funding was used to assist with the cost of oral examination visits in countries where these required specific funding. Funding was also applied to cover overhead costs for study coordinators in each contributing country, material printing and distribution and procurement of standardized examination kits for all patient assessments. This does not alter our adherence to PLOS ONE policies on sharing data and materials.

Published
2019
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49. The Long-Term Impact of Renin-Angiotensin System (RAS) Inhibition on Cardiorenal Outcomes (LIRICO): A Randomized, Controlled Trial.

Author

Saglimbene V, Palmer SC, Ruospo M, Natale P, Maione A, Nicolucci A, Vecchio M, Tognoni G, Craig JC, Pellegrini F, Lucisano G, Hegbrant J, Ariano R, Lamacchia O, Sasso A, Morano S, Filardi T, De Cosmo S, Pugliese G, Procaccini DA, Gesualdo L, Palasciano G, Johnson DW, Tonelli M, and Strippoli GFM

Subjects
Aged, Angiotensin Receptor Antagonists administration & dosage, Angiotensin Receptor Antagonists adverse effects, Angiotensin-Converting Enzyme Inhibitors administration & dosage, Angiotensin-Converting Enzyme Inhibitors adverse effects, Cardiovascular Diseases drug therapy, Cardiovascular Diseases mortality, Drug Therapy, Combination, Female, Humans, Hypertension drug therapy, Male, Middle Aged, Renin-Angiotensin System drug effects, Risk Factors, Treatment Outcome, Albuminuria drug therapy, Angiotensin Receptor Antagonists therapeutic use, Angiotensin-Converting Enzyme Inhibitors therapeutic use, Diabetes Mellitus drug therapy
Abstract

Background: The comparative effectiveness of treatment with angiotensin-converting enzyme (ACE) inhibitors, angiotensin receptor blockers (ARBs), or their combination in people with albuminuria and cardiovascular risk factors is unclear., Methods: In a multicenter, randomized, open label, blinded end point trial, we evaluated the effectiveness on cardiovascular events of ACE or ARB monotherapy or combination therapy, targeting BP<130/80 in patients with moderate or severe albuminuria and diabetes or other cardiovascular risk factors. End points included a primary composite of cardiovascular death, nonfatal myocardial infarction, nonfatal stroke, and hospitalization for cardiovascular causes and a revised end point of all-cause mortality. Additional end points included ESRD, doubling of serum creatinine, albuminuria, eGFR, BP, and adverse events., Results: Because of slow enrollment, the trial was modified and stopped 41% short of targeted enrollment of 2100 participants, corresponding to 35% power to detect a 25% reduced risk in the primary outcome. Our analysis included 1243 adults, with median follow-up of 2.7 years. Efficacy outcomes were similar between groups (ACE inhibitor versus ARB, ACE inhibitor versus combination, ARB versus combination) as were rates of serious adverse events. The rate of permanent discontinuation for ARB monotherapy (6.3%) was significantly lower than for ACE inhibitor monotherapy (15.7%) or combined therapy (18.3%)., Conclusions: Patients may tolerate ARB monotherapy better than ACE inhibitor monotherapy. However, data from this trial and similar trials, although as yet inconclusive, show no trend suggesting differences in mortality and renal outcomes with ACE inhibitors or ARBs as dual or monotherapy in patients with albuminuria and diabetes or other cardiovascular risk factors., (Copyright © 2018 by the American Society of Nephrology.)

Published
2018
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50. Prevalence and patterns of cognitive impairment in adult hemodialysis patients: the COGNITIVE-HD study.

Author

van Zwieten A, Wong G, Ruospo M, Palmer SC, Barulli MR, Iurillo A, Saglimbene V, Natale P, Gargano L, Murgo M, Loy CT, Tortelli R, Craig JC, Johnson DW, Tonelli M, Hegbrant J, Wollheim C, Logroscino G, and Strippoli GFM

Subjects
Adult, Aged, Aged, 80 and over, Cognitive Dysfunction etiology, Cohort Studies, Cross-Sectional Studies, Female, Humans, Italy epidemiology, Male, Middle Aged, Prevalence, Young Adult, Cognitive Dysfunction classification, Cognitive Dysfunction epidemiology, Renal Dialysis adverse effects
Abstract

Background: Mounting evidence indicates an increased risk of cognitive impairment in adults with end-stage kidney disease on dialysis, but the extent and pattern of deficits across the spectrum of cognitive domains are uncertain., Methods: We conducted a cross-sectional study of 676 adult hemodialysis patients from 20 centers in Italy, aiming to evaluate the prevalence and patterns of cognitive impairment across five domains of learning and memory, complex attention, executive function, language and perceptual-motor function. We assessed cognitive function using a neuropsychological battery of 10 tests and calculated test and domain z-scores using population norms (age or age/education). We defined cognitive impairment as a z-score  ≤ -1.5., Results: Participants' median age was 70.9 years (range 21.6-94.1) and 262 (38.8%) were women. Proportions of impairment on each domain were as follows: perceptual-motor function 31.5% (150/476), language 41.2% (273/662), executive function 41.7% (281/674), learning and memory 42.2% (269/638), complex attention 48.8% (329/674). Among 474 participants with data for all domains, only 28.9% (n  =  137) were not impaired on any domain, with 25.9% impaired on a single domain (n  =  123), 17.3% on two (n  =  82), 13.9% on three (n  =  66), 9.1% on four (n  =  43) and 4.9% (n  =  23) on all five. Across patients, patterns of impairment combinations were diverse., Conclusions: In conclusion, cognitive impairment is extremely common in hemodialysis patients, across numerous domains, and patients often experience multiple deficits simultaneously. Clinical care should be tailored to meet the needs of patients with different types of cognitive impairment and future research should focus on identifying risk factors for cognitive decline.

Published
2018
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