| Autor: |
Rose, Matthias, Fischer, Felix H., Liegl, Gregor, Strippoli, Giovanni F.M., Hockham, Carina, Vernooij, Robin W.M., Barth, Claudia, Canaud, Bernard, Covic, Adrian, Cromm, Krister, Cucui, Andrea M., Davenport, Andrew, Fischer, Kathrin I., Hegbrant, Jörgen, Jaha, Hanna, Schappert, Anna, Török, Marietta, Woodward, Mark, Bots, Michiel L., Blankestijn, Peter J. |
| Zdroj: |
Kidney International; November 2024, Vol. 106 Issue: 5 p961-971, 11p |
| Abstrakt: |
In the CONVINCE trial, the primary analysis demonstrated a survival benefit for patients receiving high-dose hemodiafiltration (HDF) as compared with high-flux hemodialysis (HD). A secondary objective was to evaluate effects on health-related quality of life (HRQoL); assessed in eight domains (physical function, cognitive function, fatigue, sleep disturbance, anxiety, depression, pain interference, social participation) applying instruments from the Patient-Reported Outcome Measurement Information System (PROMIS) before randomization and every three months thereafter. In total 1360 adults with dialysis-dependent chronic kidney disease, eligible to receive high-flux HDF (23 liters or more), were randomized (1:1); 84% response rate to all questionnaires. Both groups reported a continuous deterioration in all HRQoL domains. Overall, raw score changes from baseline were more favorable in the HDF group, resulting in a significant omnibus test after a median observation period of 30 months. Most relevant single raw score differences were reported for cognitive function. Patients receiving HDF reported a decline of -0.95 units (95% confidence interval - 2.23 to +0.34) whereas HD treated patients declined by -3.90 units (-5.28 to - 2.52). A joint model, adjusted for mortality differences, utilizing all quarterly assessments, identified a significantly slower HRQoL decline in physical function, cognitive function, pain interference, and social participation for the HDF group. Their physical health summary score declined -0.46 units/year slower compared to the HD group. Thus, the CONVINCE trial showed a beneficial effect of high-dose hemodiafiltration for survival as well as a moderate positive effect on patients’ quality of life, most pronounced with respect to their cognitive function. |
| Databáze: |
Supplemental Index |
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