Observational studyPediatric nephrology (Berlin, Germany)2021
Hemodiafiltration maintains a sustained improvement in blood pressure compared to conventional hemodialysis in children-the HDF, heart and height (3H) study.
Observational study in Pediatric nephrology (Berlin, Germany), 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers, 2 of them syntheses that pooled it.
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Who cites it
11 citing papers in PubMed, 2 syntheses or guidelines pooled it, 18 citations in OpenAlex.
- Management of blood pressure in adults, children and young people on dialysis: UK kidney association clinical practice guideline.BMC nephrology · 2025Guideline
- Recommendations of the Brazilian Society of Nephrology for hemodiafiltration in maintenance dialysis therapy.Jornal brasileiro de nefrologiaGuideline
- Demographics, longitudinal changes and outcome of high blood pressure in children and adolescents on kidney replacement therapy: 15 years of data from the ESPN/ERA Registry.Pediatric nephrology (Berlin, Germany) · 2026Article
- Dialysis-associated cardiovascular disease risk in children: mechanism and management.Pediatric nephrology (Berlin, Germany) · 2026Review
- Comparing outcomes with different dialysis modalities in children with kidney failure: home hemodialysis versus in-center hemodiafiltration or conventional hemodialysis.Pediatric nephrology (Berlin, Germany) · 2026Article
- Is home best when it comes to pediatric hemodialysis?Pediatric nephrology (Berlin, Germany) · 2026Article
- Haemodiafiltration versus high-flux haemodialysis-a Consensus Statement from the EuDial Working Group of the ERA.Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association · 2025Article
- Hemodiafiltration for children with stage 5 chronic kidney disease: technical aspects and outcomes.Pediatric nephrology (Berlin, Germany) · 2024Review
- Prospective Study of Modifiable Risk Factors of Arterial Hypertension and Left Ventricular Hypertrophy in Pediatric Patients on Hemodialysis.Kidney international reports · 2024Article
- The effects of hospital and dialysis unit characteristics on hospitalizations for access-related complications among children on maintenance dialysis: a European, multicenter, observational, cross-sectional study.Pediatric nephrology (Berlin, Germany) · 2023Article
- Reducing the burden of cardiovascular disease in children with chronic kidney disease: prevention vs. damage limitation.Pediatric nephrology (Berlin, Germany) · 2021Review
Corrections and comments
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Authors and funding
31 authors at 20 institutions in 10 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundHypertension is prevalent in children on dialysis and associated with cardiovascular disease. We studied the blood pressure (BP) trends and the evolution of BP over 1 year in children on conventional hemodialysis (HD) vs. hemodiafiltration (HDF).
methodsThis is a post hoc analysis of the "3H - HDF-Hearts-Height" dataset, a multicenter, parallel-arm observational study. Seventy-eight children on HD and 55 on HDF who had three 24-h ambulatory BP monitoring (ABPM) measures over 1 year were included. Mean arterial pressure (MAP) was calculated and hypertension defined as 24-h MAP standard deviation score (SDS) ≥95th percentile.
resultsPoor agreement between pre-dialysis systolic BP-SDS and 24-h MAP was found (mean difference - 0.6; 95% limits of agreement -4.9-3.8). At baseline, 82% on HD and 44% on HDF were hypertensive, with uncontrolled hypertension in 88% vs. 25% respectively; p < 0.001. At 12 months, children on HDF had consistently lower MAP-SDS compared to those on HD (p < 0.001). Over 1-year follow-up, the HD group had mean MAP-SDS increase of +0.98 (95%CI 0.77-1.20; p < 0.0001), whereas the HDF group had a non-significant increase of +0.15 (95%CI -0.10-0.40; p = 0.23). Significant predictors of MAP-SDS were dialysis modality (β = +0.83 [95%CI +0.51 - +1.15] HD vs. HDF, p < 0.0001) and higher inter-dialytic-weight-gain (IDWG)% (β = 0.13 [95%CI 0.06-0.19]; p = 0.0003).
conclusionsChildren on HD had a significant and sustained increase in BP over 1 year compared to a stable BP in those on HDF, despite an equivalent dialysis dose. Higher IDWG% was associated with higher 24-h MAP-SDS in both groups.
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