Comparison of the impact of high-flux dialysis on mortality in hemodialysis patients with and without residual renal function

Hyung Wook Kim, Su Hyun Kim, Young Ok Kim, Dong Chan Jin, Ho Chul Song, Euy Jin Choi, Yong Lim Kim, Yon Su Kim, Shin-Wook Kang, Nam Ho Kim, Chul Woo Yang, Yong Kyun Kim

Research output: Contribution to journalArticle

7 Citations (Scopus)

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 β2-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 hresidual 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.

Original languageEnglish
Article numbere97184
JournalPloS one
Volume9
Issue number6
DOIs
Publication statusPublished - 2014 Jun 6

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hemodialysis
Dialysis
renal function
dialysis
Renal Dialysis
Dialysis membranes
Fluxes
Kidney
Mortality
Residual Volume
urine
Membranes
Urine
Korea
kidney diseases
cohort studies
Proportional Hazards Models
multivariate analysis
Chronic Kidney Failure
Observational Studies

All Science Journal Classification (ASJC) codes

  • Biochemistry, Genetics and Molecular Biology(all)
  • Agricultural and Biological Sciences(all)

Cite this

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. / Comparison of the impact of high-flux dialysis on mortality in hemodialysis patients with and without residual renal function. In: PloS one. 2014 ; Vol. 9, No. 6.
@article{71291f98cc914b71af5a4bf2a78e1e0d,
title = "Comparison of the impact of high-flux dialysis on mortality in hemodialysis patients with and without residual renal function",
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 β2-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 hresidual 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.",
author = "Kim, {Hyung Wook} and Kim, {Su Hyun} and Kim, {Young Ok} and Jin, {Dong Chan} and Song, {Ho Chul} and Choi, {Euy Jin} and Kim, {Yong Lim} and Kim, {Yon Su} and Shin-Wook Kang and Kim, {Nam Ho} and Yang, {Chul Woo} and Kim, {Yong Kyun}",
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doi = "10.1371/journal.pone.0097184",
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Kim, HW, Kim, SH, Kim, YO, Jin, DC, Song, HC, Choi, EJ, Kim, YL, Kim, YS, Kang, S-W, Kim, NH, Yang, CW & Kim, YK 2014, 'Comparison of the impact of high-flux dialysis on mortality in hemodialysis patients with and without residual renal function', PloS one, vol. 9, no. 6, e97184. https://doi.org/10.1371/journal.pone.0097184

Comparison of the impact of high-flux dialysis on mortality in hemodialysis patients with and without residual renal function. / 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.

In: PloS one, Vol. 9, No. 6, e97184, 06.06.2014.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Comparison of the impact of high-flux dialysis on mortality in hemodialysis patients with and without residual renal function

AU - Kim, Hyung Wook

AU - Kim, Su Hyun

AU - Kim, Young Ok

AU - Jin, Dong Chan

AU - Song, Ho Chul

AU - Choi, Euy Jin

AU - Kim, Yong Lim

AU - Kim, Yon Su

AU - Kang, Shin-Wook

AU - Kim, Nam Ho

AU - Yang, Chul Woo

AU - Kim, Yong Kyun

PY - 2014/6/6

Y1 - 2014/6/6

N2 - 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 β2-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 hresidual 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.

AB - 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 β2-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 hresidual 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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