3H (HDF, Heart and Height) Study:

Treatment Outcomes with Hemodiafiltration vs. Hemodialysis in Children

3H is a multicentre, prospective observational cohort study to test the hypothesis that HDF dialysis modality is associated with an improved cardiovascular risk profile, growth and quality of life, compared to use of conventional HD in children. The hemodiafiltration, heart and height (3H) study includes the largest cohort of children and adolescents on dialysis to date, and compares cardiac and vascular function, growth, biochemical markers and patient related outcome measures in children receiving post-dilution on-line HDF vs conventional HD.

The 3H study has shown that sub-clinical cardiovascular disease is prevalent in children on dialysis, and an attenuated progression of vascular changes is seen in a cohort of children receiving HDF, compared to children receiving conventional HD. Within one year of conventional HD the cIMT increased by 0.41 SDS, whereas there was no change in HDF patients. On fully adjusted analyses the annualized changes in both cIMT-SDS and MAP-SDS were significantly lower in HDF compared to HD patients, correlating with improved fluid removal as well as clearance of middle molecular weight uraemic toxins by HDF. Childrens’ tolerance of HDF treatment was significantly better although children were not blinded to treatment modality.

Ongoing sub-studies: 
  • Biomarkers of bone disease
  • Nutrition, inflammation and growth in children 
  • BP and volume control
  • Anaemia and its management
  • Health related quality of life outcomes
  • Vascular endothelial growth factors
Contact Information:Rukshana Shroff

Active ESCAPE Participants:

Further 3H Investigators:

Colette Smith, Bruno Ranchin, Constantinos J Stefanidis, Varvara Askiti, Ayşe Ağbaş, Helen Aitkenhead, Ali Anarat, Bilal Aoun, Daley Aofolaju, Sevcan Bakkaloglu, Devina Bhowruth, Dagmara Borzych-Dużałka, Rainer Büscher, John Deanfield, Claire Dempster, Sandra Habbig, Shivram Hegde, Saoussen Krid, Christoph Licht, Sevgi Mir, Rose Nemec, Fabio Paglialonga, Stefano Picca, Charlotte Samaille, Mohan Shenoy, Manish D Sinha, Brankica Spasojevic, Karel Vondrák, Michel Fischbach