Korean J Intern Med.
2016 Nov;31(6):1131-1139. 10.3904/kjim.2015.111.
The impact of blood flow rate during hemodialysis on all-cause mortality
- Affiliations
-
- 1Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea. drkimyk@catholic.ac.kr
- 2Department of Internal Medicine, Chung-Ang University College of Medicine, Seoul, Korea.
- 3Department of Internal Medicine, Kyungpook National University School of Medicine, Daegu, Korea.
- 4Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea.
- 5Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea.
- 6Department of Internal Medicine, Chonnam National University Medical School, Gwangju, Korea.
- 7Cell Death Disease Research Center, College of Medicine, The Catholic University of Korea, Seoul, Korea.
- KMID: 2382863
- DOI: http://doi.org/10.3904/kjim.2015.111
Abstract
- BACKGROUND/AIMS
Inadequacy of dialysis is associated with morbidity and mortality in chronic hemodialysis (HD) patients. Blood flow rate (BFR) during HD is one of the important determinants of increasing dialysis dose. However, the optimal BFR is unclear. In this study, we investigated the impact of the BFR on all-cause mortality in chronic HD patients.
METHODS
Prevalent HD patients were selected from Clinical Research Center registry for end-stage renal disease cohort in Korea. We categorized patients into two groups by BFR < 250 and ≥ 250 mL/min according to the median value of BFR 250 mL/min in this study. The primary outcome was all-cause mortality.
RESULTS
A total of 1,129 prevalent HD patients were included. The number of patients in the BFR < 250 mL/min was 271 (24%) and in the BFR ≥ 250 mL/min was 858 (76%). The median follow-up period was 30 months. Kaplan-Meier analysis showed that the mortality rate was significantly higher in patients with BFR < 250 mL/min than those with BFR ≥ 250 mL/min (p = 0.042, log-rank). In the multivariate Cox regression analyses, patients with BFR < 250 mL/min had higher all-cause mortality than those with BFR ≥ 250 mL/min (hazard ratio, 1.66; 95% confidence interval, 1.00 to 2.73; p = 0.048).
CONCLUSIONS
Our data showed that BFR < 250 mL/min during HD was associated with higher all-cause mortality in chronic HD patients.
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