Dialyzer membrane permeability and survival in hemodialysis patients (original) (raw)

2005, American journal of …

the French Study Group for Nutrition in Dialysis • Background: We previously showed that nutritional protein concentrations were predictive of outcome, whereas variables reflecting body composition and dialysis dose were not, in a 30-month prospective follow-up of 1,610 hemodialysis patients. Information on dialysis membrane and erythropoietin use had to be evaluated in an additional follow-up. Methods: A subset of 650 patients from the initial cohort of 1,610 was analyzed for survival in a 2-year extension of follow-up. Detailed data were collected: demographics; cause of renal failure; time on dialysis therapy; type of membrane; erythropoietin treatment; body mass index (BMI); predialysis albumin, prealbumin, and bicarbonate levels; and outcome. Normalized protein catabolic rate (nPCR), dialysis adequacy, and lean body mass were computed from predialysis and postdialysis urea and creatinine values. Results: Patient characteristics were age of 61 ؎ 16 years, 58% men, BMI of 22.7 ؎ 4.4 kg/m 2 , time on dialysis therapy of 102 ؎ 73 months, and 8.8% had diabetes. Dialysis parameters were duration of 247 ؎ 31 minutes, Kt/V of 1.4 ؎ 0.3, and nPCR of 1.2 ؎ 0.3 g/kg/d. Albumin level was 3.73 ؎ 0.53 g/dL (37.3 ؎ 5.3 g/L), and prealbumin level was 31 ؎ 8 mg/dL. The survival rate was 78.7% after 2 years. Survival was influenced by age, presence of diabetes, use of high-flux membrane, and serum albumin level, but not other variables, including Kt/V and prealbumin level. Two-year variations in values for urea, creatinine, and weight were predictive of survival in univariate, but not multivariate, analyses. Conclusion: In patients on dialysis therapy for a long period, better survival was observed when high-flux dialysis membranes were used. Am J Kidney Dis 45:565-571.