The Effect of Online Hemodiafiltration on Infections : Results from the CONvective TRAnsport STudy
| Autor: | Hoedt, C.H. den, Grooteman, M.P.C., Bots, M.L., Blankestijn, P.J., Tweel, I. van der, Weerd, N.C. van der, Penne, E.L., Mazairac, A.H., Levesque, R., Wee, P.M. Ter, Nube, M.J., Dorpel, M.A. van den, Hamersvelt, H.W. van |
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| Přispěvatelé: | Nephrology, ICaR - Circulation and metabolism |
| Jazyk: | angličtina |
| Rok vydání: | 2015 |
| Předmět: |
Male
Risk medicine.medical_specialty medicine.medical_treatment lcsh:Medicine Hemodiafiltration Research Support law.invention Sepsis MORBIDITY Randomized controlled trial law Internal medicine Hemofiltration medicine Journal Article Humans Comparative Study Skin Diseases Infectious lcsh:Science Non-U.S. Gov't Respiratory Tract Infections ALL-CAUSE MORTALITY OUTCOMES Multidisciplinary Respiratory tract infections integumentary system Proportional hazards model business.industry Incidence (epidemiology) Research Support Non-U.S. Gov't lcsh:R Hazard ratio Bacterial Infections Middle Aged medicine.disease Surgery HOSPITALIZATION Randomized Controlled Trial CHRONIC-HEMODIALYSIS PATIENTS RISK-FACTORS lcsh:Q Female Hemodialysis Renal disorders Radboud Institute for Health Sciences [Radboudumc 11] business Kidneys Artificial Research Article |
| Zdroj: | PLoS One, 10 PLoS ONE [E], 10(8). Public Library of Science PLoS One, 10, 8 PLoS ONE, 10(8). Public Library of Science PLoS ONE PLoS ONE, Vol 10, Iss 8, p e0135908 (2015) den Hoedt, C H, Grooteman, M P C, Bots, M L, Blankestijn, P J, van der Tweel, I, van der Weerd, N C, Penne, E L, Mazairac, A H, Levesque, R, ter Wee, P M, Nube, M J & van den Dorpel, M A 2015, ' The Effect of Online Hemodiafiltration on Infections: Results from the CONvective TRAnsport STudy ', PLoS ONE, vol. 10, no. 8, e0135908 . https://doi.org/10.1371/journal.pone.0135908 PLoS ONE, 10(8):e0135908. Public Library of Science |
| ISSN: | 1932-6203 |
| DOI: | 10.1371/journal.pone.0135908 |
| Popis: | Contains fulltext : 152801.PDF (Publisher’s version ) (Open Access) BACKGROUND: Hemodialysis (HD) patients have a high risk of infections. The uremic milieu has a negative impact on several immune responses. Online hemodiafiltration (HDF) may reduce the risk of infections by ameliorating the uremic milieu through enhanced clearance of middle molecules. Since there are few data on infectious outcomes in HDF, we compared the effects of HDF with low-flux HD on the incidence and type of infections. PATIENTS AND METHODS: We used data of the 714 HD patients (age 64 +/-14, 62% men, 25% Diabetes Mellitus, 7% catheters) participating in the CONvective TRAnsport STudy (CONTRAST), a randomized controlled trial evaluating the effect of HDF as compared to low-flux HD. The events were adjudicated by an independent event committee. The risk of infectious events was compared with Cox regression for repeated events and Cox proportional hazard models. The distributions of types of infection were compared between the groups. RESULTS: Thirty one percent of the patients suffered from one or more infections leading to hospitalization during the study (median follow-up 1.96 years). The risk for infections during the entire follow-up did not differ significantly between treatment arms (HDF 198 and HD 169 infections in 800 and 798 person-years respectively, hazard ratio HDF vs. HD 1.09 (0.88-1.34), P = 0.42. No difference was found in the occurrence of the first infectious event (either fatal, non-fatal or type specific). Of all infections, respiratory infections (25% in HDF, 28% in HD) were most common, followed by skin/musculoskeletal infections (21% in HDF, 13% in HD). CONCLUSIONS: HDF as compared to HD did not result in a reduced risk of infections, larger studies are needed to confirm our findings. TRIAL REGISTRATION: ClinicalTrials.gov NCT00205556. |
| Databáze: | OpenAIRE |
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