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In the backwater of convective dialysis: decreased 25-hydroxyvitamin D levels following the switch to online hemodiafiltration.
Region Östergötland, Heart and Medicine Center, Department of Nephrology. Linköping University, Department of Medical and Health Sciences. Linköping University, Faculty of Medicine and Health Sciences. Tallin University of Technology, Tallin, Estonia.
Linköping University, Department of Clinical and Experimental Medicine, Division of Microbiology and Molecular Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Center for Diagnostics, Department of Clinical Chemistry.
Karolinska Instituet, Karolinska University Hospital, Stockholm.
Linköping University, Department of Medical and Health Sciences, Division of Drug Research. Region Östergötland, Heart and Medicine Center, Department of Nephrology. Linköping University, Faculty of Medicine and Health Sciences.
2015 (English)In: Clinical Nephrology, ISSN 0301-0430, Vol. 83, no 6, 315-21 p.Article in journal (Refereed) Published
Abstract [en]

BACKGROUND/AIMS: Vitamin D deficiency and elevated serum fibroblast growth factor-23 (FGF23) levels are hallmark features and surrogate markers of adverse clinical outcomes in patients with chronic kidney disease (CKD). Convection of molecules over the dialysis membrane during online hemodiafiltration (ol-HDF) increases the removal of larger waste molecules compared with traditional high-flux hemodialysis (HD). The primary aim of this study was to explore the long-term impact of ol-HDF on serum 25(OH)D and FGF23.

METHOD: An observational, prospective, noncomparator study including 35 patients who were switched from HD to ol-HDF. Serum 25(OH)D and FGF23 were measured at baseline (i.e., time of switch to ol-HDF) and at 6, 12, and 24 months.

RESULTS: At follow-up time points, there was a significant reduction in serum 25(OH)D compared with baseline (p < 0.0001) whereas FGF23 was unaltered (p > 0.05). The decrease in 25(OH)D was more prominent in individuals with higher baseline 25(OH)D levels.

CONCLUSION: Ol-HDF may lower systemic 25(OH)D levels by convective mechanisms although the clinical significance remains unknown. Further controlled studies are warranted to replicate these findings in larger patient cohorts.

Place, publisher, year, edition, pages
DUSTRI-VERLAG DR KARL FEISTLE , 2015. Vol. 83, no 6, 315-21 p.
National Category
Urology and Nephrology
Identifiers
URN: urn:nbn:se:liu:diva-119669DOI: 10.5414/CN108468ISI: 000364530600001PubMedID: 25943141OAI: oai:DiVA.org:liu-119669DiVA: diva2:826149
Note

Funding agencies:  Linkoping University Hospital Research Fund (County Council of Ostergotland); Linkoping University Hospital Research Fund (Linkoping University); Signhild Engkvists Stiftelse in Stockholm

Available from: 2015-06-24 Created: 2015-06-24 Last updated: 2016-04-24

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Uhlin, FredrikMagnusson, PerFernström, Anders
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Department of NephrologyDepartment of Medical and Health SciencesFaculty of Medicine and Health SciencesDivision of Microbiology and Molecular MedicineDepartment of Clinical ChemistryDivision of Drug Research
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Clinical Nephrology
Urology and Nephrology

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