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Kidney Week

Abstract: FR-PO417

Improved Quality of Life in Postdilution Compared to Predilution Hemodiafiltration in a European Cohort of Dialysis Patients

Session Information

Category: Dialysis

  • 801 Dialysis: Hemodialysis and Frequent Dialysis

Authors

  • Haarhaus, Mathias, Diaverum AB, Malmö, Sweden
  • Santos Araujo, Carla Alexandra R., Diaverum AB, Malmö, Sweden
  • Silva, Eliana, Diaverum AB, Malmö, Sweden
  • Lucas, Carlos, Diaverum AB, Malmö, Sweden
  • Silva, Israel Pereira, Diaverum AB, Malmö, Sweden
  • Pearce, Suzanne H., Diaverum AB, Malmö, Sweden
  • Macario, Fernando Jose Gordinho Rocha Maio, Diaverum AB, Malmö, Sweden
Background

Predilution and postdilution hemodiafiltration (HDF) affect solute removal differently, but the effect on patient reported outcomes is not well described. We describe differences in quality of life in prevalent hemodialysis (HD) patients with predilution and postdilution HDF.

Methods

In a cross-sectional study of 18.018 European prevalent HD patients from an international dialysis network, we identified 5.227 patients with HDF. All 317 patients with predilution HDF were compared to 317 propensity-score matched patients with postdilution HDF. KDQOL-36 results were compared between groups. Multivariable regression models were used to identify independent predictors of symptom/problem list, physical health composite (PHC), and mental health composite (MHC).

Results

Patients were comparable with respect to age, gender, diabetes, comorbidity, vascular access, dialysis vintage, and BMI. Patients with postdilution HDF demonstrated better results for symptom/problem list, PHC, MHC, and most KDQOL SF-36 domains (Figure 1). Multivariable regression revealed independent associations of predilution HDF with lower results for symptom/problem list (coefficient B (95% confidence interval) -6.6 (-9.5 - -3.7), p<0.001), PHC (-3.1 (-4.6 - -1.6), p<0.001), and MHC (-2.4 (-4.1 - -0.7), p=0.006).

Conclusion

We demonstrate improved quality of life in postdilution, compared to predilution HDF in a cross-sectional analysis of a multinational European prevalent hemodialysis population.

Figure 1. Differences in KDQOL SF-36 domains between pre- and postdilution HDF