Comparison of the Impact of High-Flux Dialysis on Mortality in Hemodialysis Patients with and without Residual Renal Functionopen access
- Authors
- Kim, Hyung Wook; Kim, Su-Hyun; Kim, Young Ok; Jin, Dong Chan; Song, Ho Chul; Choi, Euy Jin; Kim, Yong-Lim; Kim, Yon-Su; Kang, Shin-Wook; Kim, Nam-Ho; Yang, Chul Woo; Kim, Yong Kyun
- Issue Date
- Jun-2014
- Publisher
- PUBLIC LIBRARY SCIENCE
- Citation
- PLOS ONE, v.9, no.6
- Journal Title
- PLOS ONE
- Volume
- 9
- Number
- 6
- URI
- https://scholarworks.bwise.kr/cau/handle/2019.sw.cau/12140
- DOI
- 10.1371/journal.pone.0097184
- ISSN
- 1932-6203
- Abstract
- Background: The effect of flux membranes on mortality in hemodialysis (HD) patients is controversial. Residual renal function (RRF) has shown to not only be as a predictor of mortality but also a contributor to beta 2-microglobulin clearance in HD patients. Our study aimed to determine the interaction of residual renal function with dialyzer membrane flux on mortality in HD patients. Methods: HD Patients were included from the Clinical Research Center registry for End Stage Renal Disease, a prospective observational cohort study in Korea. Cox proportional hazards regression models were used to study the association between use of high-flux dialysis membranes and all-cause mortality with RRF and without RRF. The primary outcome was all-cause mortality. Results: This study included 893 patients with 24 h-residual urine volume >= 100 ml (569 and 324 dialyzed using low-flux and high-flux dialysis membranes, respectively) and 913 patients with 24 h-residual urine volume < 100 ml (570 and 343 dialyzed using low-flux and high-flux dialysis membranes, respectively). After a median follow-up period of 31 months, mortality was not significantly different between the high and low-flux groups in patients with 24 h-residual urine volume >= 100 ml (HR 0.86, 95% CI, 0.38-1.95, P = 0.723). In patients with 24 h-residual urine volume < 100 ml, HD using high-flux dialysis membrane was associated with decreased mortality compared to HD using low-flux dialysis membrane in multivariate analysis (HR 0.40, 95% CI, 0.21-0.78, P = 0.007). Conclusions: Our data showed that HD using high-flux dialysis membranes had a survival benefit in patients with 24 h-residual urine volume < 100 ml, but not in patients with 24 h-residual urine volume >= 100 ml. These findings suggest that high-flux dialysis rather than low-flux dialysis might be considered in HD patients without RRF.
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