2a) Faculty disclosures are listed at https://t.co/PHlIppl6Yw. There was no industry support for this program. Please also check out, for more 🆓credit, the #blogposts edited by @sophia_kidney @brian_rifkin @ghobby at https://t.co/Zap2Al75YO.
— @CKD_ce (@ckd_ce) January 17, 2024
3) According to USRDS data in 2022 the 5-year survival rate for patients on dialysis was only 40%!! 🔓 https://t.co/pKS6DjXSwA
— @CKD_ce (@ckd_ce) January 17, 2024
4b) A person on #hemodialysis at 40, only has, on average, 10 more years to live
— @CKD_ce (@ckd_ce) January 17, 2024
🔓 https://t.co/WUJKjx7Gvs pic.twitter.com/hhB9uaYDxq
6) @askrenal #askrenal
— @CKD_ce (@ckd_ce) January 17, 2024
Before we start, do you use #HDF in your current practice?
a. Yesss
b. No, not CONVINCed
c. Wish, limited resources
8) If you’re not yet CONVINCEd, note that the kidneys actually filter the blood via convection rather than diffusion. See comprehensive explanation from @kidney_boy 👇https://t.co/Glk17DeDV5
— @CKD_ce (@ckd_ce) January 17, 2024
9b) See 👇@NephJC critical discussion #visualabstract by @nephvishnoi https://t.co/ZudY42TwXd pic.twitter.com/CdZZQpvPXK
— @CKD_ce (@ckd_ce) January 17, 2024
10b) The correct answer is C—truly high! This was supported by an earlier meta-analysis that showed a survival benefit with #HDF when a convection volume was delivered at that dose or higher.
— @CKD_ce (@ckd_ce) January 17, 2024
🔓 https://t.co/F3NNEXb5A3
12) But, is 23L/session an achievable goal?
— @CKD_ce (@ckd_ce) January 17, 2024
This follow-on analysis, by the #CONVINCE authors, aimed to see if at 3 &6 months of follow-up, how many pts managed to achieve the convective target.https://t.co/XnrY0zQ5Qa pic.twitter.com/WcCqD8xeuf
14) For both HDF and high-flux HD:
— @CKD_ce (@ckd_ce) January 17, 2024
🗓️3x/week
⏰≥ 4 hours
🧂Bicarbonate-based dialysis fluid
💦High-flux synthetic dialyser
🌊Ultrapure dialysis fluid
16) Methods
— @CKD_ce (@ckd_ce) January 17, 2024
🧮Calculated proportion of pts who achieved a convection vol≥ 23L (± 1L) at each of their first 3 scheduled visits
🧮Narrative synthesis on clinical notes justification why pts missed high-dose convective vol 🎯
18) 🔷75 patients (11.5%) missed high-dose HDF target 1X, 27 (4.1%) missed it 2x, 11 (1.7%) missed it 3x
— @CKD_ce (@ckd_ce) January 17, 2024
🔷No differences in terms of which visit (baseline, visit 1, or 2) pts missed the target once
🔷61 dialysis centers: no significant differences in achieving 🎯 pic.twitter.com/B4Qbn2cH6y
20) Pts who missed the high-dose HDF target on ≥2 visits:
— @CKD_ce (@ckd_ce) January 17, 2024
⬇️extracorporeal blood flow rate (335 [44] ml/min vs. 372 [54] ml/min)
♀️Women 53% vs 35%, P=0.029
🍯diabetes 51% vs 32%, P=0.015
⚖️❗️No differences in vascular access and dialysis session duration pic.twitter.com/NkEsoThvMF
21b) Comparing to other HDF literature:
— @CKD_ce (@ckd_ce) January 17, 2024
🔷2 studies included a relatively young patient population with low CVD history
🔷 Only extracorporeal blood flow rate & treatment time were previously associated with achieving adequate HDF volume targets. pic.twitter.com/9VJPRwFlK2
23) To recap the CONVINCE meta-analysis, take a look at this beautiful #visualabstract by @hellokidneyMD
— @CKD_ce (@ckd_ce) January 17, 2024
Are you CONVINCEd to adopt HDF? pic.twitter.com/yIEd8ExF7e
24b) It’s b, decrease in all-cause mortality. #ESHOL trial gave hope of lower CV mortality (HR 0.67, 95% CI, 0.44-1.02)
— @CKD_ce (@ckd_ce) January 17, 2024
☕️ #CONVINCE: only overall survival was statistically significant (HR 0.77; 95%CI, 0.65 to 0.93), not CV mortality.
🔓ESHOL trial: https://t.co/6pmleRlvVJ
26a) You just earned 0.5hr 🆓CE/CME! Claim your certificate now at https://t.co/VviHINZvBH and share this #tweetorial with your followers and friends! Thanks to @nephroseeker for authoring & @sophia_kidney for managing!#FOAMed #nephtwitter @ISNkidneycare @KIReports @goKDIGO
— @CKD_ce (@ckd_ce) January 17, 2024
26b) Special thanks also to @ghobby and @brian_rifkin for help with this tweetorial and to @ISNKidneyCare for the opportunity pic.twitter.com/L4kXFIUxMZ
— @CKD_ce (@ckd_ce) January 17, 2024