Korean J Intern Med.
2014 Nov;29(6):774-784. 10.3904/kjim.2014.29.6.774.
The impact of high-flux dialysis on mortality rates in incident and prevalent hemodialysis patients
- Affiliations
-
- 1Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea. drkimyk@catholic.ac.kr
- 2Department of Internal Medicine, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea, Suwon, Korea.
- 3Department of Internal Medicine, Chung-Ang University College of Medicine, Seoul, Korea.
- 4Department of Internal Medicine, Kyungpook National University School of Medicine, Daegu, Korea.
- 5Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea.
- 6Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea.
- 7Department of Internal Medicine, Chonnam National University Medical School, Gwangju, Korea.
- KMID: 2070135
- DOI: http://doi.org/10.3904/kjim.2014.29.6.774
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.
Keyword
MeSH Terms
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Aged
Chi-Square Distribution
Female
Humans
Incidence
Kaplan-Meier Estimate
Kidney Failure, Chronic/diagnosis/*mortality/*therapy
Male
Middle Aged
Multivariate Analysis
Prevalence
Proportional Hazards Models
Prospective Studies
Registries
Renal Dialysis/adverse effects/methods/*mortality
Republic of Korea/epidemiology
Risk Factors
Time Factors
Treatment Outcome
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