Long-term online hemodiafiltration does not reduce the frequency and severity of acquired cystic kidney disease in hemodialysis patients.

Abstract:

BACKGROUND:Acquired cystic kidney disease (ACKD) is a frequent complication in chronic hemodialysis (HD) patients and a risk factor for renal cell carcinoma. Online hemodiafiltration (HDF) provides better clearance of middle molecular weight solutes, but its effect on ACKD has not been investigated. MATERIALS AND METHODS:This case-control study enrolled 86 patients (43 HDF patients and 43 HD patients) who were matched according to age, sex, and duration of renal replacement therapy. The mean duration of HDF was 63 (+/- 35) months. The frequency and severity of ACKD was evaluated by ultrasonography using a severity scoring system. RESULTS:We observed ACKD in 23 of the HD patients (53.5%) and 21 of the HDF patients (48.8%). This difference was not statistically significant (p = 0.829). The overall ACKD severity scores were similar in the two groups (p = 0.875). Patients on HDF had significantly lower serum levels of alkaline phosphatase and intact parathyroid hormone. Multiple logistic regression analysis indicated that duration of renal replacement therapy was the only risk factor for the presence of ACKD (p < 0.001). There was a significant correlation between duration of renal replacement therapy and ACKD severity score (r = 0.589, p < 0.001). CONCLUSIONS:Our results suggest that long-term online HDF does not reduce the frequency and severity of ACKD in dialysis patients. Duration of renal replacement therapy is the most important risk factor for ACKD. Factors that cannot be corrected by use of HDF may contribute to the formation of renal cysts.

journal_name

Ren Fail

journal_title

Renal failure

authors

Weng CJ,Chang MY,Chen YC,Tian YC,Fang JT,Yang CW

doi

10.1080/08860220903003412

subject

Has Abstract

pub_date

2009-01-01 00:00:00

pages

555-61

issue

7

eissn

0886-022X

issn

1525-6049

pii

10.1080/08860220903003412

journal_volume

31

pub_type

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