Effect of membrane flux and dialyzer biocompatibility on survival in end-stage diabetic nephropathy.
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.
Götz
Angela K
AK
Klinik und Poliklinik für Innere Medizin II, University of Regensburg, Germany. angela.goetz@klinik.uni-regensburg.de
Böger
Carsten A
CA
Popal
Massoud
M
Banas
Bernhard
B
Krämer
Bernhard K
BK
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
D001672:Biocompatible Materials; D008567:Membranes, Artificial