The effect of high-volume online haemodiafiltration on nutritional status and body composition: the ProtEin Stores prEservaTion (PESET) study

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Title: The effect of high-volume online haemodiafiltration on nutritional status and body composition: the ProtEin Stores prEservaTion (PESET) study
Authors: Molina, Pablo | Vizcaíno, Belén | Molina Vila, María Dolores | Beltrán, Sandra | González-Moya, Mercedes | Mora, Antonio | Castro-Alonso, Cristina | Kanter, Julia | Ávila, Ana I. | Górriz, José L. | Estañ, Nuria | Pallardó, Luis M. | Fouque, Denis | Carrero, Juan
Research Group/s: Bioquímica Aplicada/Applied Biochemistry (AppBiochem) | Laboratorio de Optimización (LOPT)
Center, Department or Service: Universidad de Alicante. Departamento de Matemáticas
Keywords: Body composition | Haemodiafiltration | Haemodialysis | Nutrition | Protein-energy wasting
Knowledge Area: Estadística e Investigación Operativa
Issue Date: 1-Jul-2018
Publisher: Oxford University Press
Citation: Nephrology Dialysis Transplantation. 2018, 33(7): 1223-1235. doi:10.1093/ndt/gfx342
Abstract: Background. Compared with conventional haemodialysis (HD), online haemodiafiltration (OL-HDF) achieves a more efficient removal of uraemic toxins and reduces inflammation, which could favourably affect nutritional status. We evaluate the effect of OL-HDF on body composition and nutritional status in prevalent high-flux HD (HF-HD) patients. Methods. In all, 33 adults with chronic kidney disease (CKD) Stage 5 undergoing maintenance HF-HD were assigned to post-dilution OL-HDF (n = 17) or to remain on HF-HD (n = 16, control group) for 12 months. The primary outcome was the change in lean tissue mass (LTM), intracellular water (ICW) and body cell mass (BCM) assessed by multifrequency bioimpedance spectroscopy (BIS) at baseline and 4, 8 and 12 months. The rate of change in these parameters was estimated with linear mixed-effects models. Results. Compared with OL-HDF, patients assigned to HF-HD experienced a gradual reduction in LTM, ICW and BCM. These differences reached statistical significance at Month 12, with a relative difference of 7.31 kg [95% confidence interval (CI) 2.50–12.11; P = 0.003], 2.32 L (95% CI 0.63–4.01; P = 0.008) and 5.20 kg (95% CI 1.74–8.66; P = 0.004) for LTM, ICW and BCM, respectively. The normalized protein appearance increased in the OL-HDF group compared with the HF-HD group [0.26 g/kg/day (95% CI 0.05–0.47); P = 0.002], with a relative reduction in high-sensitive C-reactive protein [−13.31 mg/dL (95% CI −24.63 to −1.98); P = 0.02] at Month 12. Conclusions. OL-HDF for 1 year compared with HF-HD preserved muscle mass, increased protein intake and reduced the inflammatory state related to uraemia and dialysis, supporting the hypothesis that high convection volume can benefit nutritional status and prevent protein-energy wasting in HD patients.
URI: http://hdl.handle.net/10045/77158
ISSN: 0931-0509 (Print) | 1460-2385 (Online)
DOI: 10.1093/ndt/gfx342
Language: eng
Type: info:eu-repo/semantics/article
Rights: © The Author 2018. Published byOxford University Press on behalf of ERA-EDTA.
Peer Review: si
Publisher version: https://doi.org/10.1093/ndt/gfx342
Appears in Collections:INV - AppBiochem - Artículos de Revistas
INV - LOPT - Artículos de Revistas
INV - GESTA - Artículos de Revistas

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