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Mashup Score: 0Hemodiafiltration's US Launch: A New Chapter in Kidney Care Technology and Evidence Featured at Kidney Week - 1 month(s) ago
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Nephrology With Joel Topf, MD
NephrologyDr. Topf is an assistant clinical professor of medicine at Oakland University William Beaumont School of Medicine, creator and host of the Freely Filtered and Channel Your Enthusiasm podcasts, creator of the Precious Bodily Fluids blog, and co-creator of NephMadness and NephJC.
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Mashup Score: 0
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The grand daddy of them all, the CONVINCE Trial. The largest RCT of HDF versus conventional HD. It showed a convincing 23% reduction in total mortality, though this came largely from a reduction in infectious etiologies rather than the expected reduction in CV death.
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Mashup Score: 0HDF vs HD: Need for CONVINCE-ing Evidence - 1 month(s) ago
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NephJC's package on CONVINCE with visual abstract and ten-tweet tweetorial.
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Mashup Score: 0Hemodiafiltration versus Hemodialysis in End-Stage Kidney Disease: A Systematic Review and Meta-Analysis - 1 month(s) ago
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Meta-analysis of hemodialfiltration from April of this year:
Analytical Approach
We included RCTs evaluating HDF versus HD. Crossover trials and studies with overlapping populations were excluded. Two authors independently extracted the data following predefined search criteria and quality assessment. The risk of bias was assessed with Cochrane’s RoB2 tool.Results
We included 5 RCTs with 4,143 patients, of which 2,078 (50.1%) underwent HDF, whereas 2,065 (49.8%) were receiving HD. Overall, HDF was associated with a lower risk of all-cause mortality (risk ratio [RR], 0.81; 95% confidence interval [CI], 0.73-0.91; P<0.001; I2=7%) and a lower risk of CV-related deaths (RR, 0.75; 95% CI, 0.61-0.92; P=0.007; I2=0%). The incidence of infection-related deaths was also significantly different between therapies (RR, 0.69; 95% CI, 0.50-0.95; P=0.02; I2=26%).Limitations
In individual studies, the HDF groups achieved varying levels of convection volume.Conclusions
Compared with those undergoing HD, patients receiving HDF experienced a reduction in all-cause mortality, CV mortality, and infection-related mortality. These results provide compelling evidence supporting the use of HDF as a beneficial intervention in ESKD patients undergoing KRT.
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Mashup Score: 0
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In this short thread Eric Weinhandl suggests that the quality of life improvements found in CONVINCE's HDF RCT were more modest than those found in the Frequent Hemodialysis Network's findings on daily dialysis and daily nocturnal dialysis. Swapnil is not impressed with either studies's results.
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Mashup Score: 0Top Nephrology Stories of 2024 - 1 month(s) ago
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As the world wobbles on its axis and we continue to live in interesting times, many of us wish we could go back to a more mundane daily news cycle. Be that as it may, it has been yet another eventful year in the nephrology and NephJC universe. Innovations in diagnosis and treatment of glomerular diseases, better studies on blood pressure and hyponatremia correction goals, xenotransplantation and HIF-PHIs rise and falls, and of course (as always) the nephrology match and workforce woes. Please follow the link and rank your top ten nehrology storis of 2024 in order. 1-for the best, 10-for the least.
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Mashup Score: 0ApEx Pathshala 2024 - 1 month(s) ago
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I had the opportunity to go to Mumbai and put on a show for the audience. Roger Rodby and I went all out for our fluid and electrolyte session. We had a blast.
ApEx Pathshala is a first rate nephrology conference held in Mumbai, India every year. If you have the means I highly recommend it.
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Katie Kwon writes about the first moves to bring hemodialfiltration to the US. Fresenius has developed the 5008X dialysis machine. This device is capable of online generation of replacement fluid which allows the delivery of hemodiafiltration in outpatient dialysis centers without significant retrofitting of the water system.