title: ESHOL study reanalysis: All-cause mortality considered by competing risks and time-dependent covariates for renal transplantation.
abstract: BACKGROUND
  The ESHOL study showed that post-dilution online haemodiafiltration (OL-HDF) reduces all-cause mortality versus haemodialysis. However, during the observation period, 355 patients prematurely completed the study and, according to the study design, these patients were censored at the time of premature termination.
  
  
  METHODS
  The aim of this study was to investigate the outcome of patients who discontinued the study.
  
  
  RESULTS
  During follow-up, 207 patients died while under treatment and 47 patients died after discontinuation of the study. Compared with patients maintained on haemodialysis, those randomised to OL-HDF had lower all-cause mortality (12.4 versus 9.46 per 100 patient-years, hazard ratio and 95%CI: 0.76; [0.59-0.98], P= 0.031). For all-cause mortality by time-dependent covariates and competing risks for transplantation, the time-dependent Cox analysis showed very similar results to the main analysis with a hazard ratio of 0.77 (0.60-0.99, P= 0.043).
  
  
  CONCLUSIONS
  The results of this analysis of the ESHOL trial confirm that post-dilution OL-HDF reduces all-cause mortality versus haemodialysis in prevalent patients. The original results of the ESHOL study, which censored patients discontinuing the study for any reason, were confirmed in the present ITT population without censures and when all-cause mortality was considered by time-dependent and competing risks for transplantation.
authors.affiliation: Departamento Nefrología, Hospital Clínic, Barcelona, España. Electronic address: fmaduell@clinic.ub.es.
authors.forename: Francisco
authors.initials: F
authors.lastname: Maduell
authors.affiliation: Departamento Nefrología, Hospital Universitari Vall d'Hebron, Barcelona, España.
authors.forename: Francesc
authors.initials: F
authors.lastname: Moreso
authors.affiliation: Fresenius Medical Care, Clínica de Granollers, España.
authors.forename: Josep
authors.initials: J
authors.lastname: Mora-Macià
authors.affiliation: CETIRSA, Barcelona, España.
authors.forename: Mercedes
authors.initials: M
authors.lastname: Pons
authors.affiliation: Hospital San Antonio Abad, Vilanova i la Geltrú, Barcelona, España.
authors.forename: Rosa
authors.initials: R
authors.lastname: Ramos
authors.affiliation: Diaverum Baix Llobregat, L'Hospitalet, España.
authors.forename: Jordi
authors.initials: J
authors.lastname: Carreras
authors.affiliation: Fresenius Medical Care, Clínica de Reus, España.
authors.forename: Jordi
authors.initials: J
authors.lastname: Soler
authors.affiliation: Unidad de Bioestadística, Escuela de Medicina, Universitat Autònoma de Barcelona; Biostatistics and Data Management Platform, IDIBAPS, Hospital Clínic, Barcelona, España.
authors.forename: Ferrán
authors.initials: F
authors.lastname: Torres
mesh_terms: D000328:Adult; D000368:Aged; D002423:Cause of Death; D005260:Female; D005500:Follow-Up Studies; D017583:Hemodiafiltration; D006801:Humans; D016030:Kidney Transplantation / Q000401:mortality*; D008297:Male; D008875:Middle Aged; D016016:Proportional Hazards Models; D006435:Renal Dialysis; D012306:Risk
keywords: Convective therapies; Hemodiafiltración on-line; Intención de tratar; Intention to treat; On-line haemodiafiltration; Supervivencia; Survival; Terapias convectivas