The Council of the European Renal Association-European Dialysis Transplant Association (ERA-EDTA) has officially approved the creation of a Working Group aimed at encouraging research, communicating knowledge, teaching and contributing to education in the field of haemodialysis. The acronym EUDIAL, standing for European Dialysis Working Group, has been chosen to best summarize its activity and mission. The vision and mission of this Working Group as formulated by the ERA-EDTA are clearly identified to improve outcomes of chronic kidney disease patients by enhancing the quality of dialysis therapies in their broader sense and facilitating collaborative research in this field.
Given the increasing scientific interest in convective therapies (hemodiafiltration and hemofiltration), the working group has decided to focusing on convective renal replacement therapies as the first aim. The rationale of this first mission is supported by several facts that include an increasing interest in convective therapies translating in a rapid growth of patients treated by modern versions of these therapies and several reports suggesting an improvement in CKD patient outcomes.
In addition, the European nephrology community has been leading in this field of renal replacement therapy for more than two decades. The concept of ultrapure dialysis fluid introduced in 1987 is now accepted as a standard for all dialysis forms. The European notified bodies have certified water treatment systems and hemodialysis machines for online production of substitution fluid. The European scientific community has launched the first randomized controlled trials comparing outcomes of CKD patients treated either by hemodiafiltration/hemofiltration or conventional hemodialysis. The highest prevalence of CKD patients treated by hemodiafiltration is found in Europe and it is increasing regularly over the time.
Carlo Basile (Italy) – Chair
Sandip Mitra (United Kingdom) – Vice Chair
Christian Combe (France)
Adrian Covic (Romania)
Mehmet Kanbay (Turkey)
Dimitri Kirmizis (United Kingdom)
Vassilios Liakopoulos (Greece)
Valerie Luyckx (Switzerland)
Rukshana Shroff (United Kingdom)
Frank van der Sande (Netherlands)
HOW TO JOIN THE WORKING GROUP
Being a ordinary member of the EUDIAL means being part of a network which facilitates exchanges of ideas on basic science research and new treatment protocols.
Becoming an ordinary member of the EUDIAL is FREE OF CHARGE (ERA-EDTA Membership is not mandatory) and is also open to non-nephrologists.
By joining the EUDIAL you will receive constant updates on the Working Group initiatives be included in the Directory of EUDIAL’ ordinary members and start networking with colleagues from all over the world.
Randomized controlled trial (RCT) on incremental haemodialysis – There is growing interest in an incremental approach to haemodialysis for incident end-stage kidney disease patients, starting with one or two sessions per week. Such an approach not only seems to preserve residual kidney function (RKF) and improve health-related quality of life with similar survival rates than those observed in patients receiving the standard thrice-weekly haemodialysis regimen, but also allows saving economic resources.
The term “incremental haemodialysis” means that, in the presence of substantial RKF, both dialysis dose and frequency can be low at dialysis inception but should be progressively increased, to compensate for any subsequent reduction in RKF.
At the present time no randomized clinical trial (RCT) testing incremental haemodialysis has yet been published. To this end, the EUDIAL Working Group is starting the “RandomizEd clinicAL triaL on the effIcacy and saFety of incremental haEmodialysis” (REAL LIFE). It is a pragmatic, prospective, multicentre, open label RCT, investigator-initiated, comparing the intervention arm (incremental haemodialysis) with the control arm (standard thrice-weekly haemodialysis).
A research letter dealing with the RCT has been recently published: The reasons for a clinical trial on incremental haemodialysis. NDT, October 2020. A video is accompanying the paper. A dedicated website has been built-up: www.incrementaldialysis.eu
European dialysis centres are warmly invited to join.
The CONVINCE study, a European prospective randomised controlled trial comparing high-volume on-line haemodiafiltration and high-flux haemodialysis, sponsored by European Union’s Horizon 2020 research and innovation programme (grant agreement No 754803), has now recruited more than 500 patients from dialysis centres spread across Europe from Portugal to Romania. This trial is designed to compare all-cause mortality, cause specific mortality, hospitalisations, quality of life and health care costs between modalities (www.convincetrial.eu).
EUDIAL Pooling project of trials in HDF (ongoing) a meta-analysis of the individual patient data from the 4 prospective trials of haemodiafiltration compared to haemodialysis.
SPEEDY is a user-friendly tool for incremental haemodialysis prescription created by Prof. F. Casino and Dr C. Basile (EUDIAL Chair). It is freely available here. Read the related article on Nephrology Dialysis Transplantation here.