title: High convection volume in online post-dilution haemodiafiltration: relevance, safety and costs.
abstract: Increasing evidence suggests that treatment with online post-dilution haemodiafiltration (HDF) improves clinical outcome in patients with end-stage kidney disease, if compared with haemodialysis (HD). Although the primary analyses of three large randomized controlled trials (RCTs) showed inconclusive results, post hoc analyses of these and previous observational studies comparing online post-dilution HDF with HD showed that the risk of overall and cardiovascular mortality is lowest in patients who are treated with high-volume HDF. As such, the magnitude of the convection volume seems crucial and can be considered as the 'dose' of HDF. In this narrative review, the relevance of high convection volume in online post-dilution HDF is discussed. In addition, we briefly touch upon some safety and cost issues.
authors.affiliation: Department of Nephrology , University Medical Center Utrecht , Utrecht , The Netherlands.
authors.forename: Ira M
authors.initials: IM
authors.lastname: Mostovaya
authors.affiliation: Department of Nephrology , VU University Medical Center , Amsterdam , The Netherlands ; Institute for Cardiovascular Research VU University Medical Center (ICaR-VU), VU University Medical Center , Amsterdam , The Netherlands.
authors.forename: Muriel P C
authors.initials: MP
authors.lastname: Grooteman
authors.affiliation: Department of Medicine , Miulli General Hospital , Acquaviva delle Fonti , Italy.
authors.forename: Carlo
authors.initials: C
authors.lastname: Basile
authors.affiliation: UCL Centre for Nephrology, Royal Free Hospital , London , UK.
authors.forename: Andrew
authors.initials: A
authors.lastname: Davenport
authors.affiliation: Department of Nephrology , VU University Medical Center , Amsterdam , The Netherlands ; Institute for Cardiovascular Research VU University Medical Center (ICaR-VU), VU University Medical Center , Amsterdam , The Netherlands.
authors.forename: Camiel L M
authors.initials: CL
authors.lastname: de Roij van Zuijdewijn
authors.affiliation: Division of Nephrology, Department of Medicine , University of Würzburg , Würzburg , Germany.
authors.forename: Christoph
authors.initials: C
authors.lastname: Wanner
authors.affiliation: Department of Nephrology , VU University Medical Center , Amsterdam , The Netherlands ; Institute for Cardiovascular Research VU University Medical Center (ICaR-VU), VU University Medical Center , Amsterdam , The Netherlands.
authors.forename: Menso J
authors.initials: MJ
authors.lastname: Nubé
authors.affiliation: Department of Nephrology , University Medical Center Utrecht , Utrecht , The Netherlands.
authors.forename: Peter J
authors.initials: PJ
authors.lastname: Blankestijn
keywords: convection volume; costs; hemodiafiltration; mortality; safety