The Korean journal of internal medicine

The Korean Association of Internal Medicine (대한내과학회)
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The impact of high-flux dialysis on mortality rates in incident and prevalent hemodialysis patients

  • Kim, Hyung Wook (Department of Internal Medicine, College of Medicine, The Catholic University of Korea) ;
  • Kim, Su-Hyun (Department of Internal Medicine, Chung-Ang University College of Medicine) ;
  • Kim, Young Ok (Department of Internal Medicine, College of Medicine, The Catholic University of Korea) ;
  • Jin, Dong Chan (Department of Internal Medicine, College of Medicine, The Catholic University of Korea) ;
  • Song, Ho Chul (Department of Internal Medicine, College of Medicine, The Catholic University of Korea) ;
  • Choi, Euy Jin (Department of Internal Medicine, College of Medicine, The Catholic University of Korea) ;
  • Kim, Yong-Lim (Department of Internal Medicine, Kyungpook National University School of Medicine) ;
  • Kim, Yon-Su (Department of Internal Medicine, Seoul National University College of Medicine) ;
  • Kang, Shin-Wook (Department of Internal Medicine, Yonsei University College of Medicine) ;
  • Kim, Nam-Ho (Department of Internal Medicine, Chonnam National University Medical School) ;
  • Yang, Chul Woo (Department of Internal Medicine, College of Medicine, The Catholic University of Korea) ;
  • Kim, Yong Kyun (Department of Internal Medicine, College of Medicine, The Catholic University of Korea)
  • Received : 2014.05.09
  • Accepted : 2014.06.23
  • Published : 2014.11.01
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Abstract

Background/Aims: The effect of high-flux (HF) dialysis on mortality rates could vary with the duration of dialysis. We evaluated the effects of HF dialysis on mortality rates in incident and prevalent hemodialysis (HD) patients. Methods: Incident and prevalent HD patients were selected from the Clinical Research Center registry for end-stage renal disease (ESRD), a Korean prospective observational cohort study. Incident HD patients were defined as newly diagnosed ESRD patients initiating HD. Prevalent HD patients were defined as patients who had been receiving HD for > 3 months. The primary outcome measure was all-cause mortality. Results: This study included 1,165 incident and 1,641 prevalent HD patients. Following a median 24 months of follow-up, the mortality rates of the HF and low-flux (LF) groups did not significantly differ in the incident patients (hazard ratio [HR], 1.046; 95% confidence interval [CI], 0.592 to 1.847; p = 0.878). In the prevalent patients, HF dialysis was associated with decreased mortality compared with LF dialysis (HR, 0.606; 95% CI, 0.416 to 0.885; p = 0.009). Conclusions: HF dialysis was associated with a decreased mortality rate in prevalent HD patients, but not in incident HD patients.

Keywords

Acknowledgement

Supported by : Ministry of Health and Welfare

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