Biocompatibility and permeability of dialyzer membranes do not affect anemia, erythropoietin dosage or mortality in japanese patients on chronic non-reuse hemodialysis: a prospective cohort study from the J-DOPPS II study.
BACKGROUND
Considerable controversy exists over the impact of the biocompatibility and flux characteristics of dialyzer membranes on anemia in chronic hemodialysis patients.


METHODS
A subset of 1,207 subjects from the Japanese arm of DOPPS phase II was analyzed.


RESULTS
Patient characteristics included mean age 59 years, male sex 60%, BMI 20.6, time on dialysis therapy 7.8 years, and diabetes rate 27%. Dialysis parameters were Kt/V 1.33, and normalized protein catabolic rate 1.05 g/kg/day. Initial hemoglobin level was 10.1 g/dl. 79% were treated by intravenous erythropoietin with mean weekly doses of 4,500 IU. Hemoglobin levels and erythropoietin doses during 2-year study period were not affected by dialysis membrane biocompatibility (unmodified cellulose or biocompatible) or flux (standard or high performance). The 2-year survival rate was 90.9% and was influenced by older age, presence of cardiovascular diseases and amyloidosis, lower levels of BMI and serum albumin, but not by other variables, including dialysis membranes. Use of biocompatible membranes was associated with a lower all-cause mortality (8.3 vs. 13.0% for bioincompatible, p = 0.037), but this difference was not significant in multivariate analyses (hazard ratio 0.70, p = 0.17 by Cox multivariate analysis).


CONCLUSIONS
The biocompatibility and permeability of dialyzer membranes had no effect on anemia, erythropoietin dosage or all-cause mortality in Japanese chronic hemodialysis patients treated by non-reuse dialysis.
Yokoyama
Hitoshi
H
Kanazawa Medical University,School of Medicine, Division of Nephrology, Uchinada, Ishikawa, Japan. h-yoko@kanazawa-med.ac.jp
Kawaguchi
Takehiko
T
Wada
Takashi
T
Takahashi
Yoshinori
Y
Higashi
Takahiro
T
Yamazaki
Shin
S
Fukuhara
Shunichi
S
Akiba
Takashi
T
Akizawa
Tadao
T
Asano
Yasushi
Y
Kurokawa
Kiyoshi
K
Saito
Akira
A
D000740:Anemia / Q000453:epidemiology* / Q000517:prevention & control*; D001672:Biocompatible Materials; D015331:Cohort Studies; D015897:Comorbidity; D004334:Drug Administration Schedule; D019544:Equipment Failure Analysis; D017743:Equipment Reuse; D004921:Erythropoietin / Q000008:administration & dosage*; D005260:Female; D006801:Humans; D015994:Incidence; D007564:Japan / Q000453:epidemiology; D007676:Kidney Failure, Chronic / Q000401:mortality* / Q000534:rehabilitation*; D008297:Male; D008422:Materials Testing; D008567:Membranes, Artificial; D008875:Middle Aged; D010539:Permeability; D011446:Prospective Studies; D006435:Renal Dialysis / Q000295:instrumentation* / Q000401:mortality*; D016019:Survival Analysis; D015996:Survival Rate
D001672:Biocompatible Materials; D008567:Membranes, Artificial; D004921:Erythropoietin