title: A randomized trial of hemodiafiltration and change in cardiovascular parameters.
abstract: OBJECTIVE
  Increased left ventricular mass (LVM), low ventricular ejection fraction (EF), and high pulse-wave velocity (PWV) relate to overall and cardiovascular mortality in patients with ESRD. The aim of this study was to determine the effect of online hemodiafiltration (HDF) versus low-flux hemodialysis (HD) on LVM, EF, and PWV.
  
  
  METHODS
  Echocardiography was used to assess LVM and EF in 342 patients in the CONvective TRAnsport STudy followed for up to 4 years. PWV was measured in 189 patients for up to 3 years. Effect of HDF versus HD on LVM, EF, and PWV was evaluated using linear mixed models.
  
  
  RESULTS
  Patients had a mean age of 63 years, and 61% were male. At baseline, median LVM was 227 g (interquartile range [IQR], 183-279 g), and median EF was 65% (IQR, 55%-72%). Median PWV was 9.8 m/s (IQR, 7.5-12.0 m/s). There was no significant difference between the HDF and HD treatment groups in rate of change in LVM (HDF: change, -0.9 g/yr [95% confidence interval (95% CI), -8.9 to 7.7 g]; HD: change, 12.5 g/yr [95% CI, -3.0 to 27.5 g]; P for difference=0.13), EF (HDF: change, -0.3%/yr [95% CI, -2.3% to 1.8%]; HD: change, -3.4%/yr [95% CI, -5.9% to -0.9%]; P=0.17), or PWV (HDF: change, -0.0 m/s per year [95% CI, -0.4 to 0.4 m/s); HD: change, 0.0 m/s per year [95% CI, -0.3 to 0.2 m/s]; P=0.89). No differences in rate of change between treatment groups were observed for subgroups of age, sex, residual kidney function, dialysis vintage, history of cardiovascular disease, diabetes, or convection volume.
  
  
  CONCLUSIONS
  Treatment with online HDF did not affect changes in LVM, EF, or PWV over time compared with HD.
authors.affiliation: Department of Nephrology and, †Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands;, ‡Department of Internal Medicine, Maasstad Hospital, Rotterdam, The Netherlands;, §Department of Nephrology,, ‖Institute for Cardiovascular Research, and, ¶Department of Cardiology, VU Medical Center, Amsterdam, The Netherlands, *Department of Nephrology, Centre Hospitalier de l'Université de Montréal, St. Luc Hospital, Montréal, Québec, Canada.
authors.forename: Irina M
authors.initials: IM
authors.lastname: Mostovaya
authors.forename: Michiel L
authors.initials: ML
authors.lastname: Bots
authors.forename: Marinus A
authors.initials: MA
authors.lastname: van den Dorpel
authors.forename: Muriel P C
authors.initials: MP
authors.lastname: Grooteman
authors.forename: Otto
authors.initials: O
authors.lastname: Kamp
authors.forename: Renée
authors.initials: R
authors.lastname: Levesque
authors.forename: Piet M
authors.initials: PM
authors.lastname: Ter Wee
authors.forename: Menso J
authors.initials: MJ
authors.lastname: Nubé
authors.forename: Peter J
authors.initials: PJ
authors.lastname: Blankestijn
mesh_terms: D000368:Aged; D016009:Chi-Square Distribution; D004452:Echocardiography; D005260:Female; D017583:Hemodiafiltration / Q000009:adverse effects; D006801:Humans; D017379:Hypertrophy, Left Ventricular / Q000175:diagnosis / Q000209:etiology* / Q000503:physiopathology; D007676:Kidney Failure, Chronic / Q000150:complications / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy*; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D009426:Netherlands; D011237:Predictive Value of Tests; D063177:Pulse Wave Analysis; D006435:Renal Dialysis / Q000009:adverse effects; D013318:Stroke Volume; D013997:Time Factors; D016896:Treatment Outcome; D018487:Ventricular Dysfunction, Left / Q000175:diagnosis / Q000209:etiology* / Q000503:physiopathology; D016277:Ventricular Function, Left
keywords: cardiovascular; ejection fraction; hemodialysis; left ventricular mass; pulse-wave velocity