title: Treatment policy rather than patient characteristics determines convection volume in online post-dilution hemodiafiltration.
abstract: OBJECTIVE
  Sub-analyses of three large trials showed that hemodiafiltration (HDF) patients who achieved the highest convection volumes had the lowest mortality risk. The aims of this study were (1) to identify determinants of convection volume and (2) to assess whether differences exist between patients achieving high and low volumes.
  
  
  METHODS
  HDF patients from the CONvective TRAnsport STudy (CONTRAST) with a complete dataset at 6 months (314 out of a total of 358) were included in this post hoc analysis. Determinants of convection volume were identified by regression analysis.
  
  
  RESULTS
  Treatment time, blood flow rate, dialysis vintage, serum albumin and hematocrit were independently related. Neither vascular access nor dialyzer characteristics showed any relation with convection volume. Except for some variation in body size, patient characteristics did not differ across tertiles of convection volume.
  
  
  CONCLUSIONS
  Treatment time and blood flow rate are major determinants of convection volume. Hence, its magnitude depends on center policy rather than individualized patient prescription.
authors.affiliation: Department of Nephrology, VU Medical Center, Amsterdam, The Netherlands.
authors.forename: Isabelle
authors.initials: I
authors.lastname: Chapdelaine
authors.forename: Ira M
authors.initials: IM
authors.lastname: Mostovaya
authors.forename: Peter J
authors.initials: PJ
authors.lastname: Blankestijn
authors.forename: Michiel L
authors.initials: ML
authors.lastname: Bots
authors.forename: Marinus A
authors.initials: MA
authors.lastname: van den Dorpel
authors.forename: Renée
authors.initials: R
authors.lastname: Lévesque
authors.forename: Menso J
authors.initials: MJ
authors.lastname: Nubé
authors.forename: Piet M
authors.initials: PM
authors.lastname: ter Wee
authors.forename: Muriel P C
authors.initials: MP
authors.lastname: Grooteman
mesh_terms: D000368:Aged; D001783:Blood Flow Velocity; D049628:Body Size; D066264:Datasets as Topic; D005260:Female; D006400:Hematocrit / Q000379:methods; D017583:Hemodiafiltration / Q000009:adverse effects / Q000379:methods*; D006801:Humans; D008297:Male; D008875:Middle Aged; D017410:Practice Guidelines as Topic; D012709:Serum Albumin / Q000378:metabolism; D013997:Time Factors
chemical_list: D012709:Serum Albumin