Abstract: FR-OR112
Exploratory Post Hoc Analysis of the CONVINCE Randomized Controlled Trial: Differential Treatment Effects of Hemodiafiltration (HDF) and Hemodialysis (HD) on Quality of Life
Session Information
- Late-Breaking Science Orals - 1
October 25, 2024 | Location: Room 6C, Convention Center
Abstract Time: 05:30 PM - 05:40 PM
Category: Dialysis
- 801 Dialysis: Hemodialysis and Frequent Dialysis
Authors
- Cromm, Krister, Fresenius Medical Care AG, Bad Homburg, Hessen, Germany
- Fischer, Felix, Charite - Universitatsmedizin Berlin, Berlin, Berlin, Germany
- Barth, Claudia Maria, B. Braun Avitum AG, Melsungen, Germany
- Canaud, Bernard J., Universite de Montpellier, Montpellier, Occitanie, France
- Hegbrant, Jorgen BA, Lunds Universitet, Lund, Sweden
- Strippoli, Giovanni, Universita degli Studi di Bari Aldo Moro, Bari, Puglia, Italy
- Woodward, Mark, The George Institute for Global Health, Sydney, New South Wales, Australia
- Bots, Michiel L., Universitair Medisch Centrum Utrecht, Utrecht, Utrecht, Netherlands
- Blankestijn, Peter J., Universitair Medisch Centrum Utrecht, Utrecht, Utrecht, Netherlands
- Rose, Matthias, Charite - Universitatsmedizin Berlin, Berlin, Berlin, Germany
Group or Team Name
- The CONVINCE Scientific Committee and CONVINCE Investigators.
Background
The CONVINCE trial provided compelling evidence that high-dose HDF is associated with a reduction in all-cause mortality when compared to standard high-flux HD. On average, participants receiving HDF also reported a slower decline in their self-reported health status. So far, it is unclear whether there are specific patient groups for whom HDF is particularly effective in maintaining quality of life.
Methods
Out of 1360 participants of the multicenter, randomized controlled CONVINCE trial comparing HDF with HD, 1211 (89%) provided data on eight domains of self-reported health status (Physical Function, Fatigue, Pain Interference, Sleep Disturbance, Anxiety, Cognitive Function, Depression, Ability to Participate in Social Roles and Activities). These were assessed every 3 months over the course of the trial. We investigated differential treatment effects of HDF compared to HD by age group (<50 yrs (n = 240), 50-65 yrs (514), >65 yrs (606)), biological sex (male (856), female (504)), history of cardiovascular disease (yes (612), no (748)), diabetes at baseline (yes (481), no (879)) and dialysis vintage (<2 yrs (548), 2-5 yrs (414), >5 yrs (395)) by testing the significance of interaction terms between treatment and respective subgroup in a longitudinal linear mixed model.
Results
We observed significant differential treatment effects for dialysis vintage on physical function (p = 0.028), for age on pain interference (p = 0.044) and for history of cardiovascular disease on cognitive function (p = 0.048).
Conclusion
High-dose HDF has overall benefits on quality of life. These benefits may vary slightly between patient subgroups, but these differences appear to be small. Findings should be weighed carefully due to multiple statistical comparisons.
Funding
- Government Support - Non-U.S.