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. 2022 Aug 12;12(1):13708.
doi: 10.1038/s41598-022-17943-0.

The association between dose of hemodialysis and patients mortality in a prospective cohort study

Shu-Xin Liu  1   2 , Zhi-Hong Wang  3   4 , Shuang Zhang  3   4 , Jia Xiao  3   4 , Lian-Lian You  3   4 , Yu Zhang  3   4 , Cui Dong  3   4 , Xue-Na Wang  3   4 , Zhen-Zhen Wang  3   4 , Sheng-Nan Wang  3   4 , Jia-Ni Song  3   4 , Xiu-Nan Zhao  3   4 , Xin-Yi Yan  3   4 , Shu-Fan Yu  3   4 , Yi-Nan Zhang  3   4
Affiliations

The association between dose of hemodialysis and patients mortality in a prospective cohort study

Shu-Xin Liu et al. Sci Rep. .

Abstract

Dialysis adequacy is a known risk factor for mortality in maintenance hemodialysis (MHD) patients. However, the optimal dialysis dose remains controversial. Therefore, we aimed to explore the relationship between dialysis dose and all-cause and cardiovascular disease (CVD) mortality among MHD. We examined the associations of dialysis dose with mortality in a cohort (n = 558) of MHD patients from 31 December 2015 to 31 December 2020. Dialysis adequacy was assessed using baseline Single-pool Kt/Vurea (spKt/V), which was categorized into three groups, and the lowest dose group was used as the reference category. Hazard ratios (HRs) and 95% confidence intervals (CIs) were calculated using Cox proportional hazards regression models. A total of 214 patients died (64.5% for CVD). Compared with the low-dose group, high-dose group could reduce the risk of all-cause mortality by 33% (HR = 0.67, 95% CI: 0.47-0.98). Of note, when stratification by age, high-dose group was associated with both lower all-cause (HR = 0.46, 95% CI: 0.26-0.81) and CVD mortality (HR = 0.42, 95% CI: 0.20-0.88) among patients with age below 65 years. When stratification by dialysis age, high-dose group was associated with decreased risk of CVD mortality (HR = 0.43, 95% CI: 0.20-0.91) among patients with dialysis age over 60 months. spKt/V is a simple index of hemodialysis dose used in clinical practice and a useful modifiable factor in predicting the risk of death, especially in MHD patients under 65 years old or dialysis age more than 60 months.

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Conflict of interest statement

The authors declare no competing interests.

Figures

Figure 1
Figure 1
Kaplan–Meier survival estimates of all-cause mortality between the three the dose of hemodialysis subgroups divided by the optimal cutoff value.
Figure 2
Figure 2
Kaplan–Meier survival estimates of cardiovascular disease mortality between the three the dose of hemodialysis subgroups divided by the optimal cutoff value.
See this image and copyright information in PMC

References

    1. Global Burden of Disease Study Global, regional, and national burden of chronic kidney disease, 1990–2017: A systematic analysis for the Global Burden of Disease Study 2017. Lancet. 2020;395(10225):709–733. doi: 10.1016/S0140-6736(20)30045-3. - DOI - PMC - PubMed
    1. Zhao X, Niu Q, Gan L, Hou FF, Liang X, Ni Z, et al. Baseline data report of the China dialysis outcomes and practice patterns study (DOPPS) Sci. Rep. 2021;11(1):873. doi: 10.1038/s41598-020-79531-4. - DOI - PMC - PubMed
    1. Johansen KL, Chertow GM, Foley RN, Gilbertson DT, Herzog CA, Ishani A, et al. US renal data system 2020 annual data report: Epidemiology of kidney disease in the United States. Am. J. Kidney Dis. 2021;77(4 Suppl 1):A7–8. doi: 10.1053/j.ajkd.2021.01.002. - DOI - PMC - PubMed
    1. Lacson EJ, Wang W, Hakim RM, Teng M, Lazarus JM. Associates of mortality and hospitalization in hemodialysis: Potentially actionable laboratory variables and vascular access. Am. J. Kidney Dis. 2009;53(1):79–90. doi: 10.1053/j.ajkd.2008.07.031. - DOI - PubMed
    1. Tentori F, Hunt WC, Rohrscheib M, Zhu M, Stidley CA, Servilla K, et al. Which targets in clinical practice guidelines are associated with improved survival in a large dialysis organization? J. Am. Soc. Nephrol. 2007;18(8):2377–2384. doi: 10.1681/ASN.2006111250. - DOI - PubMed

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