Letter to the Editor
Comments on "High convective volumes are associated with improvement in metabolic profile in diabetic patients on online haemodiafiltration"
Comentarios sobre «Los altos volúmenes convectivos se asocian a la mejoría del perfil metabólico en los pacientes diabéticos en hemodiafiltración online»
Delma Veron
Facultad de Ciencias de la Salud, Universidad Estatal de Milagro, Milagro, Guayas, Ecuador
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Additionally, in individuals treated with haemodiafiltration with mean annual replacement volumes of 29.3 ± 1.7 L/session HbA1c values decreased significantly compared to those who received mean annual replacement volumes of 23.9 ± 1.9 L/session (HbA1c –0.51 ± 1.24% vs. 0.01 ± 0.88%).<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a> These observations are suggestive, however it is important to consider the analytical performance of the test used to measure HbA1c. In both clinical practice and research, quantifying HbA1c with standardised methods with good performance strengthens the reliability of the results.<a class="elsevierStyleCrossRefs" href="#bib0010"><span class="elsevierStyleSup">2–5</span></a></p><p id="par0010" class="elsevierStylePara elsevierViewall">The benefits of haemodiafiltration in individuals with advanced chronic kidney disease, who require dialysis, were attributed to its ability to remove small- (<500 Da) and medium- (0.5-40 kDa) molecular-weight substances.<a class="elsevierStyleCrossRefs" href="#bib0030"><span class="elsevierStyleSup">6,7</span></a> The improvement in dyslipidaemia, chronic inflammatory process, oxidative stress, endothelial damage, and interferences in the coagulation cascade were related to convective removal of medium-sized molecules.<a class="elsevierStyleCrossRefs" href="#bib0030"><span class="elsevierStyleSup">6,7</span></a> Assuming that the precision and accuracy of the test for measuring the HbA1c used by Macías et al. allow to distinguish the variations reported and that these observations are reproducible, what mechanisms would be involved in improved control of chronic hyperglycaemia during treatment with haemodiafiltration and high replacement volumes?</p><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0005">Funding</span><p id="par0015" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleGrantSponsor" id="gs0005">Secretary of Higher Education, Science, Technology, and Innovation of Ecuador</span>, Prometheus Project <span class="elsevierStyleGrantNumber" refid="gs0005">2015-2017</span>. <span class="elsevierStyleGrantSponsor" id="gs0010">Universidad Estatal de Milagro [Milagro State University], Guayas, Ecuador</span>: <span class="elsevierStyleGrantNumber" refid="gs0010">UNEMI-OCAS-SO-30052016-N5-DV</span>.</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Conflict of interest</span><p id="par0020" class="elsevierStylePara elsevierViewall">There are no conflicts of interest with this work.</p></span></span>" "textoCompletoSecciones" => array:1 [ "secciones" => array:4 [ 0 => array:2 [ "identificador" => "sec0005" "titulo" => "Funding" ] 1 => array:2 [ "identificador" => "sec0010" "titulo" => "Conflict of interest" ] 2 => array:2 [ "identificador" => "xack454574" "titulo" => "Acknowledgements" ] 3 => array:1 [ "titulo" => "References" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2019-03-08" "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as: Veron D. Comentarios sobre «Los altos volúmenes convectivos se asocian a la mejoría del perfil metabólico en los pacientes diabéticos en hemodiafiltración online». Nefrologia. 2020;40:111–112.</p>" ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:7 [ 0 => array:3 [ "identificador" => "bib0005" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "High convective volumes are associated with improvement in metabolic profile in diabetic patients on online haemodiafiltration" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "N. Macías" 1 => "S. Abad" 2 => "A. Vega" 3 => "S. Cedeño" 4 => "A. 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La Milia" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Nephrol Dial Transplant" "fecha" => "2018" "volumen" => "33" "paginaInicial" => "1896" "paginaFinal" => "1904" ] ] ] ] ] ] ] ] ] ] "agradecimientos" => array:1 [ 0 => array:4 [ "identificador" => "xack454574" "titulo" => "Acknowledgements" "texto" => "<p id="par0025" class="elsevierStylePara elsevierViewall">To all the people, entities, and libraries which granted us free access to the published scientific knowledge.</p>" "vista" => "all" ] ] ] "idiomaDefecto" => "en" "url" => "/20132514/0000004000000001/v1_202003180708/S2013251420300158/v1_202003180708/en/main.assets" "Apartado" => array:4 [ "identificador" => "35436" "tipo" => "SECCION" "en" => array:2 [ "titulo" => "Letters to the Editor" "idiomaDefecto" => true ] "idiomaDefecto" => "en" ] "PDF" => "https://static.elsevier.es/multimedia/20132514/0000004000000001/v1_202003180708/S2013251420300158/v1_202003180708/en/main.pdf?idApp=UINPBA000064&text.app=https://revistanefrologia.com/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2013251420300158?idApp=UINPBA000064" ]
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