title: Dialyzer membrane permeability and survival in hemodialysis patients.
abstract: BACKGROUND
  We previously showed that nutritional protein concentrations were predictive of outcome, whereas variables reflecting body composition and dialysis dose were not, in a 30-month prospective follow-up of 1,610 hemodialysis patients. Information on dialysis membrane and erythropoietin use had to be evaluated in an additional follow-up.
  
  
  METHODS
  A subset of 650 patients from the initial cohort of 1,610 was analyzed for survival in a 2-year extension of follow-up. Detailed data were collected: demographics; cause of renal failure; time on dialysis therapy; type of membrane; erythropoietin treatment; body mass index (BMI); predialysis albumin, prealbumin, and bicarbonate levels; and outcome. Normalized protein catabolic rate (nPCR), dialysis adequacy, and lean body mass were computed from predialysis and postdialysis urea and creatinine values.
  
  
  RESULTS
  Patient characteristics were age of 61 +/- 16 years, 58% men, BMI of 22.7 +/- 4.4 kg/m2 , time on dialysis therapy of 102 +/- 73 months, and 8.8% had diabetes. Dialysis parameters were duration of 247 +/- 31 minutes, Kt/V of 1.4 +/- 0.3, and nPCR of 1.2 +/- 0.3 g/kg/d. Albumin level was 3.73 +/- 0.53 g/dL (37.3 +/- 5.3 g/L), and prealbumin level was 31 +/- 8 mg/dL. The survival rate was 78.7% after 2 years. Survival was influenced by age, presence of diabetes, use of high-flux membrane, and serum albumin level, but not other variables, including Kt/V and prealbumin level. Two-year variations in values for urea, creatinine, and weight were predictive of survival in univariate, but not multivariate, analyses.
  
  
  CONCLUSIONS
  In patients on dialysis therapy for a long period, better survival was observed when high-flux dialysis membranes were used.
authors.affiliation: Département de Néphrologie, Centre Hospitalier Universitaire and Université Bordeaux 2, Bordeaux, France. ph.chauveau@wanadoo.fr
authors.forename: Philippe
authors.initials: P
authors.lastname: Chauveau
authors.forename: Hiep
authors.initials: H
authors.lastname: Nguyen
authors.forename: Christian
authors.initials: C
authors.lastname: Combe
authors.forename: Geneviève
authors.initials: G
authors.lastname: Chêne
authors.forename: Raymond
authors.initials: R
authors.lastname: Azar
authors.forename: Noël
authors.initials: N
authors.lastname: Cano
authors.forename: Bernard
authors.initials: B
authors.lastname: Canaud
authors.forename: Denis
authors.initials: D
authors.lastname: Fouque
authors.forename: Maurice
authors.initials: M
authors.lastname: Laville
authors.forename: Xavier
authors.initials: X
authors.lastname: Leverve
authors.forename: Hubert
authors.initials: H
authors.lastname: Roth
authors.forename: Michel
authors.initials: M
authors.lastname: Aparicio
mesh_terms: D000368:Aged; D001639:Bicarbonates / Q000097:blood; D001823:Body Composition; D015992:Body Mass Index; D002318:Cardiovascular Diseases / Q000401:mortality; D002423:Cause of Death; D002784:Cholesterol / Q000097:blood; D015897:Comorbidity; D003404:Creatinine / Q000097:blood; D003928:Diabetic Nephropathies / Q000401:mortality / Q000628:therapy; D004921:Erythropoietin / Q000627:therapeutic use; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007239:Infections / Q000401:mortality; D007676:Kidney Failure, Chronic / Q000150:complications / Q000401:mortality / Q000628:therapy*; D015993:Life Tables; D008297:Male; D008567:Membranes, Artificial; D008875:Middle Aged; D009369:Neoplasms / Q000401:mortality; D010539:Permeability; D011228:Prealbumin / Q000032:analysis; D011237:Predictive Value of Tests; D016016:Proportional Hazards Models; D011446:Prospective Studies; D011502:Protein-Energy Malnutrition / Q000209:etiology / Q000401:mortality*; D006435:Renal Dialysis / Q000295:instrumentation* / Q000379:methods; D012709:Serum Albumin / Q000032:analysis; D016019:Survival Analysis; D013997:Time Factors; D014508:Urea / Q000097:blood
chemical_list: D001639:Bicarbonates; D008567:Membranes, Artificial; D011228:Prealbumin; D012709:Serum Albumin; D004921:Erythropoietin; D014508:Urea; D002784:Cholesterol; D003404:Creatinine