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http://dx.doi.org/10.3904/kjim.2014.29.6.774

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)
Publication Information
The Korean journal of internal medicine / v.29, no.6, 2014 , pp. 774-784 More about this Journal
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
Dialysis; Renal dialysis; Mortality;
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1 Cheung AK, Greene T. Effect of membrane permeability on survival of hemodialysis patients. J Am Soc Nephrol 2009;20:462-464.   DOI   ScienceOn
2 Bradbury BD, Fissell RB, Albert JM, et al. Predictors of early mortality among incident US hemodialysis patients in the Dialysis Outcomes and Practice Patterns Study (DOPPS). Clin J Am Soc Nephrol 2007;2:89-99.
3 Lukowsky LR, Kheifets L, Arah OA, Nissenson AR, Kalantar- Zadeh K. Patterns and predictors of early mortality in incident hemodialysis patients: new insights. Am J Nephrol 2012;35:548-558.   DOI   ScienceOn
4 Soucie JM, McClellan WM. Early death in dialysis patients: risk factors and impact on incidence and mortality rates. J Am Soc Nephrol 1996;7:2169-2175.
5 Collins AJ, Foley RN, Gilbertson DT, Chen SC. The state of chronic kidney disease, ESRD, and morbidity and mortality in the first year of dialysis. Clin J Am Soc Nephrol 2009;4 Suppl 1:S5-S11.   DOI   ScienceOn
6 Hemodialysis Adequacy 2006 Work Group. Clinical practice guidelines for hemodialysis adequacy, update 2006. Am J Kidney Dis 2006;48 Suppl 1:S2-S90.   DOI   ScienceOn
7 Yoon HE, Chung S, Chung HW, et al. Status of initiating pattern of hemodialysis: a multi-center study. J Korean Med Sci 2009;24 Suppl:S102-S108.   DOI   ScienceOn
8 Cheung AK, Rocco MV, Yan G, et al. Serum beta-2 microglobulin levels predict mortality in dialysis patients: results of the HEMO study. J Am Soc Nephrol 2006;17:546-555.   DOI   ScienceOn
9 Tattersall J, Martin-Malo A, Pedrini L, et al. EBPG guideline on dialysis strategies. Nephrol Dial Transplant 2007;22 Suppl 2:ii5-ii21.   DOI
10 Yoshino M, Kuhlmann MK, Kotanko P, et al. International differences in dialysis mortality reflect background general population atherosclerotic cardiovascular mortality. J Am Soc Nephrol 2006;17:3510-3519.   DOI   ScienceOn
11 Ward RA. Do clinical outcomes in chronic hemodialysis depend on the choice of a dialyzer? Semin Dial 2011;24:65-71.   DOI   ScienceOn
12 DiRaimondo CR, Pollak VE. Beta 2-microglobulin kinetics in maintenance hemodialysis: a comparison of conventional and high-flux dialyzers and the effects of dialyzer reuse. Am J Kidney Dis 1989;13:390-395.   DOI
13 Coyne DW, Dagogo-Jack S, Klein S, Merabet E, Audrain J, Landt M. High-flux dialysis lowers plasma leptin concentration in chronic dialysis patients. Am J Kidney Dis 1998;32:1031-1035.   DOI   ScienceOn
14 Makita Z, Bucala R, Rayfield EJ, et al. Reactive glycosylation endproducts in diabetic uraemia and treatment of renal failure. Lancet 1994;343:1519-1522.   DOI   ScienceOn
15 D'Amour P, Jobin J, Hamel L, L'Ecuyer N. iPTH values during hemodialysis: role of ionized Ca, dialysis membranes and iPTH assays. Kidney Int 1990;38:308-314.   DOI   ScienceOn
16 Dhondt A, Vanholder R, Van Biesen W, Lameire N. The removal of uremic toxins. Kidney Int Suppl 2000;76:S47-S59.
17 Hornberger JC, Chernew M, Petersen J, Garber AM. A multivariate analysis of mortality and hospital admissions with high-flux dialysis. J Am Soc Nephrol 1992;3:1227-1237.
18 Port FK, Wolfe RA, Hulbert-Shearon TE, et al. Mortality risk by hemodialyzer reuse practice and dialyzer membrane characteristics: results from the usrds dialysis morbidity and mortality study. Am J Kidney Dis 2001;37:276-286.   DOI   ScienceOn
19 Chauveau P, Nguyen H, Combe C, et al. Dialyzer membrane permeability and survival in hemodialysis patients. Am J Kidney Dis 2005;45:565-571.   DOI   ScienceOn
20 Krane V, Krieter DH, Olschewski M, et al. Dialyzer membrane characteristics and outcome of patients with type 2 diabetes on maintenance hemodialysis. Am J Kidney Dis 2007;49:267-275.   DOI   ScienceOn
21 Gotz AK, Boger CA, Popal M, Banas B, Kramer BK. Effect of membrane flux and dialyzer biocompatibility on survival in end-stage diabetic nephropathy. Nephron Clin Pract 2008;109:c154-c160.   DOI   ScienceOn
22 Eknoyan G, Beck GJ, Cheung AK, et al. Effect of dialysis dose and membrane flux in maintenance hemodialysis. N Engl J Med 2002;347:2010-2019.   DOI   ScienceOn
23 Cheung AK, Levin NW, Greene T, et al. Effects of highflux hemodialysis on clinical outcomes: results of the HEMO study. J Am Soc Nephrol 2003;14:3251-3263.   DOI   ScienceOn
24 Locatelli F, Martin-Malo A, Hannedouche T, et al. Effect of membrane permeability on survival of hemodialysis patients. J Am Soc Nephrol 2009;20:645-654.   DOI   ScienceOn