A randomised-control trial has shown that one type of treatment for kidney failure – haemodiafiltration – works significantly better than haemodialysis.
More than 10% of the world’s population is estimated to have chronic kidney disease.
The end stage of kidney disease is kidney failure, or renal failure, where the kidneys can no longer keep the blood clean. Patients either need a form of dialysis or a kidney transplant to stay alive.
Haemodialysis – removing blood, then using an artificial kidney to clean it and return it to the body – is one of the most common ways to treat kidney failure.
Haemodiafiltration is a newer technique that combines haemodialysis with another filtration method that removes larger molecules from the blood.
It’s also a common treatment, but not as common as haemodialysis, and some countries like the US don’t use it at all.
Haemodiafiltration is also not suitable for every patient, because it needs a higher blood flow to work.
A study published in New England Journal of Medicine has found that haemodiafiltration has a significantly lower mortality rate than haemodialysis.
The researchers conducted a trial, called the CONVINCE Trial, with 1,360 patients with kidney failure, from eight European countries.
The participants were randomly assigned to either hemodiafiltration (683 people) or hemodialysis (677 people).
The researchers followed up with patients roughly 30 months later.
Mortality from any source was 21.9% among patients who had haemodialysis, and 17.3% among those who had haemodiafiltration.
Thus means that the patients who used haemodafiltration were 23% less likely to die.
“Our results show clear survival benefits for using haemodiafiltration over haemodialysis to treat kidney failure, akin to a 23% reduction in all-cause mortality,” says research lead Professor Peter Blankestijn, a researcher at UMC Utrecht, Netherlands.
“My hope is that haemodiafiltration can become the new standard.”
The researchers have also collected outcomes reported by patients in the trial, and will be reporting on them in more detail next year.
“During my career I’ve watched new treatments emerge for many diseases, from diabetes to cancer, but we haven’t seen the same advances in the treatment of chronic kidney disease,” says senior author Professor Andrew Devonport, a researcher art University College London, UK.
“This study proves that targeting different molecules through haemodiafiltration has clear benefits for patients. I would say that this is the first major step forward in many years and is good news for kidney disease patients and their families.”