title: Modifiable factors associated with achievement of high-volume post-dilution hemodiafiltration: results from an international study.
abstract: BACKGROUND
  The aim was to investigate factors associated with the successful achievement of ≥21 l/session of substitution fluid volume in patients on post-dilution hemodiafiltration.
  
  
  METHODS
  3315 patients treated in 6 European countries with the Fresenius 5008 CorDiax machine including the AutoSub Plus feature were considered. Variables that showed a relationship with convection volume were entered in a multivariable logistic regression model.
  
  
  RESULTS
  Mean blood flow was 379 ± 68 ml/min. Median substitution volume was 24.7 L (IQR 22.0-27.4 L). Mean filtration fraction was 28.3 ± 4.1%. 81.5% of sessions qualified as high-volume HDF (substitution volumes ≥21 L). Higher age, dialyzer surface area, blood flow and treatment time were positively associated with the achievement of ≥21 L substitution volume; higher body mass index, male gender, higher hematocrit, graft or catheter vs. fistula, and start of week vs. mid-week were negatively associated.
  
  
  CONCLUSIONS
  Dialysis center policy in terms of blood flow, treatment time, filter size, and perhaps even hemoglobin targets plays a key role in achieving high-volume HDF. All of these are modifiable factors that can help in prescribing an optimal combination of dialyzer size, achievable blood flows, and treatment times.
authors.affiliation: Fresenius Medical Care, Bad Homburg - Germany.
authors.forename: Daniele
authors.initials: D
authors.lastname: Marcelli
authors.forename: Pascal
authors.initials: P
authors.lastname: Kopperschmidt
authors.forename: Inga
authors.initials: I
authors.lastname: Bayh
authors.forename: Tomas
authors.initials: T
authors.lastname: Jirka
authors.forename: Jose I
authors.initials: JI
authors.lastname: Merello
authors.forename: Pedro
authors.initials: P
authors.lastname: Ponce
authors.forename: Erzebeth
authors.initials: E
authors.lastname: Ladanyi
authors.forename: Attilio
authors.initials: A
authors.lastname: Di Benedetto
authors.forename: Reina
authors.initials: R
authors.lastname: Dovc-Dimec
authors.forename: Jaroslav
authors.initials: J
authors.lastname: Rosenberger
authors.forename: Stefano
authors.initials: S
authors.lastname: Stuard
authors.forename: Caecilia
authors.initials: C
authors.lastname: Scholz
authors.forename: Aileen
authors.initials: A
authors.lastname: Grassmann
authors.forename: Bernard
authors.initials: B
authors.lastname: Canaud
mesh_terms: D000368:Aged; D001783:Blood Flow Velocity / Q000502:physiology; D004867:Equipment Design; D005260:Female; D017583:Hemodiafiltration / Q000379:methods*; D006801:Humans; D007676:Kidney Failure, Chronic / Q000628:therapy*; D008297:Male; D008875:Middle Aged