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Abstract. Background: Mortality rates remain high for haemodialysis (HD) patients and simply increasing the HD dose to remove more small solutes does not improve survival. Online haemodiafiltration (HDF) provides additional clearance of larger toxins compared with standard HD.
- Sanne A.E. Peters, Michiel L. Bots, Bernard Canaud, Andrew Davenport, Muriel P.C. Grooteman, Fatih K...
- 2016
Contributors: Rob C M van Kruijsdijk; Robin W M Vernooij; Michiel L Bots; Sanne A E Peters; Jannick A N Dorresteijn; Frank L J Visseren; Peter J Blankestijn; Thomas P A Debray; Michiel L Bots; Peter J Blankestijn et al.
Sanne A.E. PETERS, Research fellow in Epidemiology | Cited by 7,277 | of University of Oxford, Oxford (OX) | Read 102 publications | Contact Sanne A.E. PETERS
- Introduction
- Materials and Methods
- Results
- Discussion
- Conclusion
Approximately 10% of the general population suffers from kidney damage, and a proportion will progress into end-stage kidney disease (ESKD). ESKD ranks among the most severe chronic non-communicable diseases . Haemodialysis (HD) has become the standard renal replacement therapy for patients with ESKD, with >2 million patients now treated worldwide....
Study design
A pooled IPD analysis was undertaken using data from systematically identified large multicentre randomized controlled trials (RCTs) that assessed the effects of online HDF versus HD on mortality endpoints in adult patients undergoing chronic HD . To ensure adequate event follow-up and reasonable power for mortality endpoints, studies had to be designed to examine the effects of HDF on mortality endpoints. Moreover, since not all convective dialysis therapies are equal, we avoided making...
Study populations
A detailed description of the study design, patient eligibility criteria and treatment procedures of each of the studies meeting the inclusion criteria has been provided elsewhere [7–9, 10]. CONTRAST included 714 patients treated by HD for >2 months in dialysis centres in the Netherlands, Canada and Norway . Online HDF was performed with a suggested target convection volume of 6 L/h, i.e. generally 24 L/per session. ESHOL included 906 patients treated by HD for >3 months in Spain , with...
Study endpoint and follow-up
The primary outcome was all-cause mortality. Secondary outcomes were mortality from cardiovascular causes, infections and sudden death. Follow-up procedures differed across studies. CONTRAST patients who discontinued randomized treatment due to renal transplantation, modality switch to peritoneal dialysis, moving to a non-participating centre or other reasons continued to be followed for the primary and main secondary outcomes. However, mortality follow-up data were incomplete for 355 (39%) o...
Of the 2793 patients included, 38% were women. The mean age was 64 (standard deviation 15) years, 29% had diabetes mellitus and 35% a history of CVD. At the start of the study, patients had been established on dialysis for a median of 33 (Q1–Q3: 15–64) months and 85% had vascular access through an arteriovenous fistula (Table 1 and Supplementary da...
This pooled IPD analysis of RCTs showed that online HDF reduced the risk of all-cause mortality and cardiovascular mortality compared with HD in patients with ESKD requiring HD. There was no evidence to suggest that the beneficial effect of online HDF differed across patient subgroups. However, the survival benefit of online HDF seems to largely de...
This large-scale IPD analysis on the effects of online HDF compared with conventional HD indicates that online HDF reduces the risk of mortality in ESKD patients, especially if applied sufficiently dosed (greater than ∼23 L/session, i.e. greater than ∼69 L/week). The precise mechanisms for this effect remain to be elucidated. A next study should ad...
- Sanne A.E. Peters, Michiel L. Bots, Bernard Canaud, Andrew Davenport, Muriel P.C. Grooteman, Fatih K...
- 2016
Nov 7, 2018 · Abstract. Objectives: To investigate sex differences in risk factors for incident myocardial infarction (MI) and whether they vary with age. Design: Prospective population based study. Setting: UK Biobank. Participants: 471 998 participants (56% women; mean age 56.2) with no history of cardiovascular disease.
- Elizabeth R C Millett, Sanne A E Peters, Sanne A E Peters, Mark Woodward, Mark Woodward
- 2018
Sanne Peters is an Associate Professor in Epidemiology and Global Health at the Julius Center for Health Sciences and Primary Care. She holds a joint appointment as Associate Professor at The George Institute for Global Health, University of New South Wales and as Senior Lecturer, Faculty of Medicine, Imperial College London.
Estimates of the ratio of the RRs (RRR), comparing women with men, were computed. Results: Data from 116 cohorts, over 22 million individuals, and over 1 million CVD events, suggest that lower SES is associated with increased risk of CHD, stroke and CVD in women and men.
