Effect of changing treatment to high-flux hemodialysis (HFHD) on mortality in patients with long-term low flux hemodialy
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RESEARCH ARTICLE
Open Access
Effect of changing treatment to high-flux hemodialysis (HFHD) on mortality in patients with long-term low flux hemodialysis (LFHD): a propensity score matched cohort study Shuxin Liu*, Hong Liu, Zhihong Wang, Lanbo Teng, Cui Dong, Tingting Gui and Yu Zhang
Abstract Background: 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). Methods: The 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. Results: K-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%. Conclusion: The prognosis of patients with ESRD who performed long-term LFHD can be significantly improved after changing to HFHD. Keywords: High-flux hemodialysis, Low-flux hemodialysis, End-stage renal disease, Prognosis, Propensity score matched cohort study
* Correspondence: [email protected] Department of Nephrology, Dalian municipal central hospital, No. 826, Southwest Road, Dalian, Liaoning Province 116033, PR China © The Author(s). 2020 Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedi
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