Abstract: SA-PO872
The Course of Peri-Dialytic Blood Pressure over Time in Online Post-Dilution Hemodiafiltration Is Not Influenced by the Magnitude of the Convection Volume
Session Information
- Dialysis: Cardiovascular, BP, Volume
October 27, 2018 | Location: Exhibit Hall, San Diego Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Dialysis
- 701 Dialysis: Hemodialysis and Frequent Dialysis
Authors
- Rootjes, Paul A., VU University Medical Center, Amsterdam, Netherlands
- de Roij van Zuijdewijn, Camiel LM, VU University Medical Center, Amsterdam, Netherlands
- Blankestijn, Peter J., University Medical Center----, Utrecht, Netherlands
- Canaud, Bernard J., FMC Deutschland GmbH, Bad Homburg, Germany
- Davenport, Andrew, Royal Free Hospital, London, United Kingdom
- van Ittersum, Frans J., VU University Medical Center Amsterdam, Amsterdam, Netherlands
- Grooteman, Muriel P., VU University Medical Center, Amsterdam, Netherlands
- Maduell, Francisco, Hospital Clinic Barcelona, Barcelona, Spain
- Nube, Menso, VU Medical Center, Bergen, Netherlands
Group or Team Name
- on behalf of the HDF Pooling Project Investigators.
Background
Online post-dilution hemodiafiltration (HDF) is associated with a lower mortality rate than conventional hemodialysis (HD). The mechanism(s) behind this effect is (are) unknown. In a previous analysis on chronic HD and HDF patients we showed first, that pre- and post-dialytical (peri-dialytic) systolic blood pressure (SBP), diastolic BP (DBP) and mean arterial pressure (MAP) declined over time, while pulse pressure (PP) increased. Second, differences between HD and HDF patients were not observed. Since the beneficial effect of HDF is highly dependent on the magnitude of the convection volume (CV), in the present analysis we investigated whether different CVs have a dissimilar influence on the course of peri-dialytic BP over time.
Methods
We used the pooled individual participant data (IPD) from the Spanish Estudio de Supervivencia de Hemodiafiltración (ESHOL, n=906), the Dutch Convective Transport Study (CONTRAST, n=714) and the French HDF study (Frenchie, n=391) (Peters SAE et al. Nephrol Dial Transplant 2016 31 978). The CV was divided in quartiles (<20L, 20-23L, 23-26L and >26L). Hereafter, we investigated whether the change in BP over time was different for these quartiles by using an interaction term (convection volume * time) in linear mixed models.
Results
The longitudinal courses of the pre- and post-dialysis SBP, DBP, MAP and PP were similar in the CV quartiles (P >0.05 for all interaction terms).The difference between pre- and post-dialysis values (delta) was also similar in all 4 categories.
Conclusion
The course of the peri-dialytical and delta SBP, DBP, MAP and PP over time in HDF patients is not related to the magnitude of the CV. Therefore, the lower mortality rate in HDF patients may not depend on a superior peri-dialytic BP regulation.