FP452EVOLUTION OF N-TERMINAL PRO-B-TYPE NATRIURETIC PEPTIDE IN PATIENTS UNDERGOING HIGH EFFICIENCY ON-LINE HEMODIAFILTRATION VERSUS CONVENTIONAL LOW-FLUX HEMODIALYSIS
Notice bibliographique
Résumé
INTRODUCTION AND AIMS: Recent large randomized clinical trials suggested that on-line hemodiafiltration (HDF) had a beneficial effect on survival compared to conventional low-flux hemodialysis (HD), mostly due to a reduction in fatal cardiac events. N-terminal pro-B-type natriuretic peptide (NT-proBNP) has been linked to the risk of cardiovascular and all-cause mortality in the dialysis population. With its 8400 Da molecular weight, NT-proBNP is cleared by HDF during treatment. However, little is still known as to long-term evolution of pre-dialysis NT-proBNP according to dialysis modality. The aim of this study was to determine the effect of HDF vs HD on NT-proBNP at 1-year follow-up. METHODS: Patients were randomized from 2007 to 2013 to HD or HDF in accordance with the CONvective TRAnsport STudy (CONTRAST) protocol initially (until 2010) and subsequently as part of the local cohort (2010-2013). Patients with a myocardial infarction within 2 months of randomization were excluded. NT-proBNP were obtained before dialysis session and analyzed at baseline and at 1-year follow-up. Comparisons of the evolution of NT-proBNP between groups were performed with the Mann-Whitney test. RESULTS: A total of 53 HDF patients and 58 HD patients were included. Patients on HDF and HD were comparable both for clinical characteristics and for dialysis treatment parameters. Prior to randomization, all patients had been previously treated with conventional hemodialysis. At baseline, median NT-proBNP value was 3490 ng/L (IQR 1716—12 620) in the HDF group vs. 5267 (2122—17 127) in the HD group (p=0.272). Dialysis was provided according to randomization with comparable dialysis session time and frequency. HDF sessions were performed in post-dilution mode and convection volume was 28.6 L (IQR 26.2-31.4) in the HDF group. At 1-year follow-up, median NT-proBNP remained stable at 2584 ng/L (IQR 1375—8406) in the HDF group (p=0.566 vs. baseline), but had increased to 9962 (2823-30 545) in the HD group (p= 0.001 vs. baseline, p=0.001 vs. HDF). The median variation (delta) in NT-proBNP values was +135 ng/L (IQR -1727—1155) in the HDF group or +7% (-53%-+51%) vs. +2009 ng/L (-95-+12 043) or +33% (-7%-162%) in the HD group (p=0.003 between groups). CONCLUSIONS: Treatment with high-efficiency HDF is associated with stability in NT-proBNP values whereas low-flux HD is associated with an increase in NT-proBNP levels at 1-year follow-up. Future studies are needed to establish whether those variations in NT-proBNP values are a consequence of higher filtration, or rather a protective cardiac effect of HDF, or a mix of both, and if they are related to better clinical outcomes in HDF patients.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,001 | 0,001 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,001 | 0,001 |
| Bibliométrie | 0,000 | 0,000 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,001 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».