@entity4346 in incident dialysis XXXX randomized to treatment with hemofiltration or hemodialysis: results from the ProFil study.

@entity1 @entity4346 @entity65 @entity1002
INTRODUCTION: @entity4346 ( @entity4346 ) is present in a majority of hemodialysis (HD) @entity1 and is among the strongest risk factors for cardiovascular events and mortality. Hemofiltration (HF), a purely convective dialysis treatment, has been associated with enhanced hemodynamic stability compared with HD, possibly as a result of a more physiologic removal of fluid and solutes. METHODS: In a randomized controlled study conducted at ten dialysis centers in Sweden and Denmark, incident @entity1 (HD <3 months) without clinical signs or history of @entity65 were randomized to treatment with either online, predilution HF or low-flux HD. The primary endpoint was change in @entity1002 ( @entity1002 ), as measured by two-dimensional M-mode and Doppler echocardiography. RESULTS: The analyses included 34 @entity1 (18 HF, 16 HD) followed for up to 2 years. At baseline, 65% of the @entity1 had @entity4346 , but @entity1002 did not differ between the study groups. In the HF group, @entity1002 decreased by 22    48 g/m(2) during a mean treatment time of 19    7 months, while in the HD group the decrease was 15    57 g/m(2) during 16    7 months. As analyzed by MANOVA (mixed model), the difference in @entity1002 over the whole period was statistically significant (p = 0.03) with a more favorable outcome in HF. Blood pressure and other study variables did not differ between the groups, but at baseline and throughout the study, HF @entity1 required heavier antihypertensive treatment. CONCLUSIONS: In incident dialysis @entity1 , long-term predilution HF, a purely convective dialysis treatment, is associated with a significantly more favorable development of @entity1002 compared with regular low-flux HD. Considering the predictive strength of @entity1002 as a risk factor, the quantitative difference between the treatments is of clinical importance.
