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

8 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

    Fingerprint

All Science Journal Classification (ASJC) codes

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

Cite this

Kim, H. W., Kim, S. H., Kim, Y. O., Jin, D. C., Song, H. C., Choi, E. J., Kim, Y. L., Kim, Y. S., Kang, S. W., Kim, N. H., Yang, C. W., & Kim, Y. K. (2014). Comparison of the impact of high-flux dialysis on mortality in hemodialysis patients with and without residual renal function. PloS one, 9(6), [e97184]. https://doi.org/10.1371/journal.pone.0097184