The impact of high-flux dialysis on mortality rates in incident and prevalent hemodialysis patients.
OBJECTIVE
The effect of high-flux (HF) dialysis on mortality rates could vary with the duration of dialysis. We evaluated the effects of HF dialysis on mortality rates in incident and prevalent hemodialysis (HD) patients.


METHODS
Incident and prevalent HD patients were selected from the Clinical Research Center registry for end-stage renal disease (ESRD), a Korean prospective observational cohort study. Incident HD patients were defined as newly diagnosed ESRD patients initiating HD. Prevalent HD patients were defined as patients who had been receiving HD for > 3 months. The primary outcome measure was all-cause mortality.


RESULTS
This study included 1,165 incident and 1,641 prevalent HD patients. Following a median 24 months of follow-up, the mortality rates of the HF and low-flux (LF) groups did not significantly differ in the incident patients (hazard ratio [HR], 1.046; 95% confidence interval [CI], 0.592 to 1.847; p = 0.878). In the prevalent patients, HF dialysis was associated with decreased mortality compared with LF dialysis (HR, 0.606; 95% CI, 0.416 to 0.885; p = 0.009).


CONCLUSIONS
HF dialysis was associated with a decreased mortality rate in prevalent HD patients, but not in incident HD patients.
Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea. ; Department of Internal Medicine, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea, Suwon, Korea.
Hyung Wook
HW
Kim
Department of Internal Medicine, Chung-Ang University College of Medicine, Seoul, Korea.
Su-Hyun
SH
Kim
Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea.
Young Ok
YO
Kim
Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea. ; Department of Internal Medicine, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea, Suwon, Korea.
Dong Chan
DC
Jin
Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea.
Ho Chul
HC
Song
Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea.
Euy Jin
EJ
Choi
Department of Internal Medicine, Kyungpook National University School of Medicine, Daegu, Korea.
Yong-Lim
YL
Kim
Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea.
Yon-Su
YS
Kim
Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea.
Shin-Wook
SW
Kang
Department of Internal Medicine, Chonnam National University Medical School, Gwangju, Korea.
Nam-Ho
NH
Kim
Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea.
Chul Woo
CW
Yang
Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea.
Yong Kyun
YK
Kim
D000368:Aged; D016009:Chi-Square Distribution; D005260:Female; D006801:Humans; D015994:Incidence; D053208:Kaplan-Meier Estimate; D007676:Kidney Failure, Chronic / Q000175:diagnosis / Q000401:mortality* / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D015995:Prevalence; D016016:Proportional Hazards Models; D011446:Prospective Studies; D012042:Registries; D006435:Renal Dialysis / Q000009:adverse effects / Q000379:methods / Q000401:mortality*; D056910:Republic of Korea / Q000453:epidemiology; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome
Dialysis; Mortality; Renal dialysis