Kim Hyung Wook, Kim Su-Hyun, Kim Young Ok, Jin Dong Chan, Song Ho Chul, Choi Euy Jin, Kim Yong-Lim, Kim Yon-Su, Kang Shin-Wook, Kim Nam-Ho, Yang Chul Woo, Kim Yong Kyun
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.
Department of Internal Medicine, Chung-Ang University College of Medicine, Seoul, Korea.
Korean J Intern Med. 2014 Nov;29(6):774-84. doi: 10.3904/kjim.2014.29.6.774. Epub 2014 Oct 31.
BACKGROUND/AIMS: 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.
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.
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).
HF dialysis was associated with a decreased mortality rate in prevalent HD patients, but not in incident HD patients.
背景/目的：高通量（HF）透析对死亡率的影响可能因透析时间长短而异。我们评估了HF透析对初治和维持性血液透析（HD）患者死亡率的影响。
从韩国一项前瞻性观察队列研究——终末期肾病（ESRD）临床研究中心登记处选取初治和维持性HD患者。初治HD患者定义为新诊断的开始进行HD的ESRD患者。维持性HD患者定义为接受HD超过3个月的患者。主要结局指标为全因死亡率。
本研究纳入了1165例初治HD患者和1641例维持性HD患者。经过中位24个月的随访，初治患者中HF组和低通量（LF）组的死亡率无显著差异（风险比[HR]，1.046；95%置信区间[CI]，0.592至1.847；p = 0.878）。在维持性HD患者中，与LF透析相比，HF透析与死亡率降低相关（HR，0.606；95%CI，0.416至0.885；p = 0.009）。
HF透析与维持性HD患者死亡率降低相关，但与初治HD患者死亡率降低无关。
