Kidney Week

Abstract: FR-PO1036

Comparison of Clinical and Sociodemographic Characteristics of Hemodialysis Modalities

Session Information

• Social, Environmental, and Economic Determinants of Kidney Health
  October 25, 2024 | Location: Exhibit Hall, Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: Diversity and Equity in Kidney Health

• 900 Diversity and Equity in Kidney Health

Authors

• Alejos, Belen, Fresenius Medical Care, Bad Homburg, Hessen, Germany

Belen Alejos, PhD

• Croft, Kaitlyn Renee, Fresenius Medical Care, Bad Homburg, Hessen, Germany

Kaitlyn Renee Croft, MSc

• Winter, Anke, Fresenius Medical Care, Bad Homburg, Hessen, Germany

Anke Winter, MD

• Guinsburg, Adrian M., Fresenius Medical Care, Buenos Aires, Argentina

Adrian M. Guinsburg, MD

• Hymes, Jeffrey L., Fresenius Medical Care, Waltham, Massachusetts, United States

Jeffrey L. Hymes, MD

• Larkin, John W., Fresenius Medical Care, Waltham, Massachusetts, United States

John W. Larkin, PhD

• Usvyat, Len A., Fresenius Medical Care, Waltham, Massachusetts, United States

Len A. Usvyat, PhD

• Guinsburg, Martin Esteban, Fresenius Medical Care, Buenos Aires, Argentina

Martin Esteban Guinsburg, MD

• Maddux, Franklin W., Fresenius Medical Care AG, Bad Homburg, Hessen, Germany

Franklin W. Maddux, MD

Background

Hemodiafiltration (HDF) is a well-established kidney replacement therapy. However, the selection of the dialysis modality is normally made according to individual characteristics. We aimed to compare clinical and sociodemographic characteristics (with special interest in mineral bone disease (MBD) markers) according to hemodialysis modality among patients treated in 4 countries in Latin America in the first version of the global database (Apollo Dial DB).

Methods

Apollo Dial DB includes adult dialysis patient data from a global kidney network during Jan 2018-Mar 2021 (Fresenius Medical Care, Bad Homburg, DE). Data anonymization was performed in alignment with recommendations from a re-identification risk determination (Privacy Analytics, Ontario, CA). We included patients with HD or HDF for >90 days, with >90% of their assigned treatment for 12 weeks.

Results

A total of 20,350 patients were analyzed, 17,916 (88%) patients on HD, 2,434 (12%) on HDF. Figure shows differences in sociodemographic and clinical characteristics of the patient groups. Patients in HDF group were younger, had higher vintage, lower prevalence of preexisting CVD and diabetes, higher prevalence of fistula as vascular access, larger use of Vitamin D analogs, phosphate binders and calcimimetics. OCM Kt/V and blood flow were higher among HDF compared to HD. Slightly higher target achievement were observed for calcium and phosphate parameters on HDF group.

Conclusion

Prescription of HDF as kidney replacement therapy is not solely determined by specific guidelines but significantly influenced by various patients’ characteristics that may lead to selection bias when analyzing the treatment effect. Hyperphosphatemia is particularly an indication for HDF in most LatAm countries, therefore future research is needed to evaluate how HDF affects MBD markers independently of other patient’s factors.

Funding

• Commercial Support – Fresenius Medical Care