[Diffusive and convective treatments in the clinical practice: observation study of the Pavia district nephrology group].
PURPOSE. Although convective treatments are widely used, there is no evidence that they can improve patient survival or hospitalizations nor clinical criteria indicating which patients could benefit from them. This study was carried out to evaluate the dialysis modality distribution and the clinical criteria used in choosing the dialysis therapy by the four dialysis Centers in the district of Pavia, a district characterized by a quite homogeneous population.


METHODS
We evaluated age, gender, body mass index (BMI), time on dialysis, number of sessions per week, dialysis duration, dialysis modality, criteria used in choosing dialysis therapy, vascular access (VA), Kt/V, and the number of hypotensive episodes.


RESULTS
Two hundred and seventy-two patients were enrolled in the study. Mean age was 67.3 +/- 12 yrs, BMI was 26.3 +/- 6.1, dialytic age was 5.49 +/- 5.5 yrs, Kt/V was 1.4 +/- 0.3, mean session time was 238 min. Fifty-two patients (19.2%) were on a convective treatment. Age, BMI, time on dialysis, dialysis duration and number of sessions per week were no different between convective treatment patients and diffusive treatment patients. Kt/V was significantly different between convective and diffusive methods (1.55 +/- 0.37 vs 1.4 +/- 0.28, p<0.05). Convective treatments were prescribed for cardiovascular (CV) instability by the nephrologists from the Pavia district in the majority of patients (90.9%). There was no difference in hypotensive episodes between convective and diffusive methods.


CONCLUSIONS
Our study demonstrated that lacking clinical evidence indicating an improvement in the long-term outcome with convective techniques, nephrologists in the Pavia district choose this type of dialysis treatment to ameliorate CV stability in uremic patients.
Barbieri
C
C
U.O. di Nefrologia e Dialisi dell'Oltrepo, Pavia. Cristiana_Barberi@ospedali.pavia.it
Costa
S
S
Bellazzi
R
R
Nai
M
M
Villa
G
G
Montagna
G
G
De Mauri
A
A
Esposito
C
C
Dal Canton
A
A
D000368:Aged; D005260:Female; D006801:Humans; D007558:Italy; D008297:Male; D006435:Renal Dialysis / Q000379:methods*