Systematic review to compare the outcomes associated with the modalities of expanded hemodialysis (HDx) versus high-flux hemodialysis and/or hemodiafiltration (HDF) in patients with end-stage kidney disease (ESKD).

Autor: Mitchell CR; Systematic Review Department, Mtech Access, Bicester, UK., Hornig C; Department of Health Economics and Market Access, Fresenius Medical Care Deutschland GmbH, Bad Homburg, Germany., Canaud B; School of Medicine, Montpellier, France and Fresenius Medical Care, Global Medical Office, Montpellier University, Bad Homburg, Germany.
Jazyk: angličtina
Zdroj: Seminars in dialysis [Semin Dial] 2023 Mar; Vol. 36 (2), pp. 86-106. Date of Electronic Publication: 2022 Nov 27.
DOI: 10.1111/sdi.13130
Abstrakt: Background: This systematic review was performed to identify recent published comparative evidence on the efficacy, effectiveness, and safety of expanded hemodialysis (HDx) versus high-flux HD and/or hemodiafiltration (HDF) for long-term outcomes in end-stage kidney disease.
Methods: Systematic literature review was conducted according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) checklist. Medline, Medline® Epub Ahead of Print, EconLit, Embase, and EBM reviews were searched to identify relevant publications from 2013 onwards. Eligibility criteria included clinical studies reporting mortality, hospitalizations, cardiovascular outcomes, economic evaluations, cost studies, and quality of life (QoL) studies.
Results: A total of 79 relevant studies were identified with 29 prioritized for detailed analysis; four compared HDx to HD, one compared HDF and HDx, and 24 compared HDF with HD. A total of 13 randomized controlled trial (RCT)-based studies were identified; 11 compared HDF with HD, one compared HDx with HD, and one compared HDF with HDx. Follow-up duration ranged from 16 weeks to 7 years for HDF studies and from 12 weeks to 1 year for HDx studies. HDF showed significant improvements in mortality, cardiovascular outcomes, hospitalizations, and QoL versus high-flux HD. One study reported mortality outcomes for HDx and found no difference versus HDF. QoL benefits with HDx were reported in a small number of studies.
Conclusion: The efficacy and safety of HDF is supported by a robust evidence base that includes several RCTs. While HDx may offer benefits over high-flux HD, long-term studies are required to compare HDx with online high volume HDF.
Registration: PROSPERO registration number: CRD42022301009.
(© 2022 Fresenius Medical Care Deutschland GmbH. Seminars in Dialysis published by Wiley Periodicals LLC.)
Databáze: MEDLINE
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