title: Effect of membrane flux and dialyzer biocompatibility on survival in end-stage diabetic nephropathy.
abstract: OBJECTIVE
  We examined the effects of dialyzer membrane flux and biocompatibility on mortality in diabetic dialysis patients.
  
  
  METHODS
  We enrolled 402 prevalent chronic hemodialysis patients from 30 centers in Germany in 1999 for a prospective observational study until 2003. We compared 2 groups in post hoc analysis: high-flux (HF, n = 166) versus low-flux (LF, n = 236) membrane, and high biocompatibility (HB, n = 300) versus low biocompatibility (LB, n = 102). All-cause mortality (ACM) was the primary endpoint. Death causes were the secondary endpoints.
  
  
  RESULTS
  Multivariate Cox regression analysis showed no significant difference in risk for ACM with respect to flux (hazard ratio, HR, 0.79; p = 0.08; ACM 63% in HF vs. 70% in LF dialysis) and biocompatibility level (HR 1.00; p = 0.98; ACM 67% for HB vs. 66% for LB). The multivariate analysis of different causes of death did not reveal any outcome differences dependent on flux and biocompatibility level apart from a slightly better cumulative survival regarding the death cause 'infectious' in our HF dialysis group (HR 0.48; p = 0.07, Kaplan-Meier analysis p = 0.03).
  
  
  CONCLUSIONS
  Our data indicate that mortality of hemodialysis patients with type-2 diabetic nephropathy is influenced neither by dialyzer flux level nor by biocompatibility.
authors.affiliation: Klinik und Poliklinik für Innere Medizin II, University of Regensburg, Germany. angela.goetz@klinik.uni-regensburg.de
authors.forename: Angela K
authors.initials: AK
authors.lastname: Götz
authors.forename: Carsten A
authors.initials: CA
authors.lastname: Böger
authors.forename: Massoud
authors.initials: M
authors.lastname: Popal
authors.forename: Bernhard
authors.initials: B
authors.lastname: Banas
authors.forename: Bernhard K
authors.initials: BK
authors.lastname: Krämer
mesh_terms: D000368:Aged; D001672:Biocompatible Materials / Q000592:standards*; D015331:Cohort Studies; D003924:Diabetes Mellitus, Type 2 / Q000150:complications / Q000401:mortality* / Q000628:therapy; D003928:Diabetic Nephropathies / Q000150:complications / Q000401:mortality* / Q000628:therapy; D005260:Female; D006801:Humans; D007676:Kidney Failure, Chronic / Q000150:complications / Q000401:mortality* / Q000628:therapy; D008297:Male; D008567:Membranes, Artificial; D008875:Middle Aged; D011446:Prospective Studies; D006435:Renal Dialysis / Q000401:mortality* / Q000592:standards* / Q000639:trends; D015996:Survival Rate / Q000639:trends
chemical_list: D001672:Biocompatible Materials; D008567:Membranes, Artificial