Abstract
BackgroundThe purpose of this study was to explore the effect of changing treatment to high-flux hemodialysis (HFHD) on mortality rate in patients with long-term low flux hemodialysis (LFHD).MethodsThe patients with end-stage renal disease (ESRD) who underwent LFHD with dialysis age more than 36 months and stable condition in our hospital before December 31, 2014 were included in this study. They were divided into control group and observation group. Propensity score matched method was used to select patients in the control group. The hemodialysis was performed 3 times a week for 4 h. The deadline for follow-up is December 31, 2018. End-point event is all-cause death. The survival rates of the two groups were compared and multivariate Cox regression analysis was carried out.ResultsK-M survival analysis showed that the 1-year, 2-year, 3-year and 4-year survival rates of HFHD group were 98, 96, 96 and 96%, respectively. The 1-year, 2-year, 3-year and 4-year survival rates of LFHD group were 95, 85, 80 and 78%, respectively. Log-rank test showed that the survival rate of HFHD group was significantly higher than that of LFHD group (x2= 7.278, P = 0.007). Multivariate Cox regression analysis showed that male, age, hemoglobin and low-throughput dialysis were independent predictors of death (P < 0.05). Compared with LFHD, HFHD can significantly reduce the mortality risk ratio of patients, as high as 86%.ConclusionThe prognosis of patients with ESRD who performed long-term LFHD can be significantly improved after changing to HFHD.
Highlights
The purpose of this study was to explore the effect of changing treatment to high-flux hemodialysis (HFHD) on mortality rate in patients with long-term low flux hemodialysis (LFHD)
The annual mortality rate of patients who perform maintenance hemodialysis is about 18%, the average number of hospitalization is 1.9, and the average length of hospitalization is 14.0 days, of whom cardiovascular disease is the main cause of death [1]
General clinical features A total of 57 eligible patients were transferred from LFHD to HFHD
Summary
The purpose of this study was to explore the effect of changing treatment to high-flux hemodialysis (HFHD) on mortality rate in patients with long-term low flux hemodialysis (LFHD). Despite the continuous development of blood purification technology, the annual mortality and complications of patients with end-stage renal disease (ESRD) are still high. The annual mortality rate of patients who perform maintenance hemodialysis is about 18%, the average number of hospitalization is 1.9, and the average length of hospitalization is 14.0 days, of whom cardiovascular disease is the main cause of death [1]. Compared with low-flux hemodialysis (LFHD), high-flux hemodialysis (HFHD) can more effectively remove intermediate molecular uremic toxins with molecular weights of 5000– 15,000 Da, such as β2-MG etc. It is suggested that there are many factors that affect the prognosis of patients with ESRD, such as volume, blood pressure, anemia, inflammation, and mineral-bone metabolism disorders. Clearance of uremic toxins may be only one of the influencing factors
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