High-performance dialyzers and mortality in maintenance hemodialysis patients

Abstract Few data are available regarding the association of dialyzer type with prognosis. In Japan, dialyzers are classified as types I, II, III, IV, and V based on β2-microglobulin clearance rates of < 10, < 30, < 50, < 70, and ≥ 70 mL/min, respectively. We investigated the relationshi...

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Autores principales:	Masanori Abe, Ikuto Masakane, Atsushi Wada, Shigeru Nakai, Eiichiro Kanda, Kosaku Nitta, Hidetomo Nakamoto
Formato:	article
Lenguaje:	EN
Publicado:	Nature Portfolio 2021
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/b5aa33f4249b446a8242f0bb30161879
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spelling	oai:doaj.org-article:b5aa33f4249b446a8242f0bb301618792021-12-02T14:59:29ZHigh-performance dialyzers and mortality in maintenance hemodialysis patients10.1038/s41598-021-91751-w2045-2322https://doaj.org/article/b5aa33f4249b446a8242f0bb301618792021-06-01T00:00:00Zhttps://doi.org/10.1038/s41598-021-91751-whttps://doaj.org/toc/2045-2322Abstract Few data are available regarding the association of dialyzer type with prognosis. In Japan, dialyzers are classified as types I, II, III, IV, and V based on β2-microglobulin clearance rates of < 10, < 30, < 50, < 70, and ≥ 70 mL/min, respectively. We investigated the relationship of the 5 dialyzer types with 1-year mortality. This nationwide cohort study used data collected at the end of 2008 and 2009 by the Japanese Society for Dialysis Therapy Renal Data Registry. We enrolled 203,008 patients on maintenance hemodialysis who underwent hemodialysis for at least 1 year and were managed with any of the 5 dialyzer types. To evaluate the association of dialyzer type with 1-year all-cause mortality, Cox proportional hazards models and propensity score-matched analyses were performed. After adjustment of the data with clinicodemographic factors, the type I, II, and III groups showed significantly higher hazard ratios (HRs) than the type IV dialyzers (reference). After adjustment for Kt/V and β2-microglobulin levels, the HRs were significantly higher in the type I and II groups. After further adjustment for nutrition- and inflammation-related factors, the HRs were not significantly different between the type IV and type I and II groups. However, type V dialyzers consistently showed a significantly lower HR. With propensity score matching, the HR for the type V dialyzer group was significantly lower than that for the type IV dialyzer group. Additional long-term trials are required to determine whether type V dialyzers, which are high-performance dialyzers, can improve prognosis.Masanori AbeIkuto MasakaneAtsushi WadaShigeru NakaiEiichiro KandaKosaku NittaHidetomo NakamotoNature PortfolioarticleMedicineRScienceQENScientific Reports, Vol 11, Iss 1, Pp 1-11 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Masanori Abe Ikuto Masakane Atsushi Wada Shigeru Nakai Eiichiro Kanda Kosaku Nitta Hidetomo Nakamoto High-performance dialyzers and mortality in maintenance hemodialysis patients
description	Abstract Few data are available regarding the association of dialyzer type with prognosis. In Japan, dialyzers are classified as types I, II, III, IV, and V based on β2-microglobulin clearance rates of < 10, < 30, < 50, < 70, and ≥ 70 mL/min, respectively. We investigated the relationship of the 5 dialyzer types with 1-year mortality. This nationwide cohort study used data collected at the end of 2008 and 2009 by the Japanese Society for Dialysis Therapy Renal Data Registry. We enrolled 203,008 patients on maintenance hemodialysis who underwent hemodialysis for at least 1 year and were managed with any of the 5 dialyzer types. To evaluate the association of dialyzer type with 1-year all-cause mortality, Cox proportional hazards models and propensity score-matched analyses were performed. After adjustment of the data with clinicodemographic factors, the type I, II, and III groups showed significantly higher hazard ratios (HRs) than the type IV dialyzers (reference). After adjustment for Kt/V and β2-microglobulin levels, the HRs were significantly higher in the type I and II groups. After further adjustment for nutrition- and inflammation-related factors, the HRs were not significantly different between the type IV and type I and II groups. However, type V dialyzers consistently showed a significantly lower HR. With propensity score matching, the HR for the type V dialyzer group was significantly lower than that for the type IV dialyzer group. Additional long-term trials are required to determine whether type V dialyzers, which are high-performance dialyzers, can improve prognosis.
format	article
author	Masanori Abe Ikuto Masakane Atsushi Wada Shigeru Nakai Eiichiro Kanda Kosaku Nitta Hidetomo Nakamoto
author_facet	Masanori Abe Ikuto Masakane Atsushi Wada Shigeru Nakai Eiichiro Kanda Kosaku Nitta Hidetomo Nakamoto
author_sort	Masanori Abe
title	High-performance dialyzers and mortality in maintenance hemodialysis patients
title_short	High-performance dialyzers and mortality in maintenance hemodialysis patients
title_full	High-performance dialyzers and mortality in maintenance hemodialysis patients
title_fullStr	High-performance dialyzers and mortality in maintenance hemodialysis patients
title_full_unstemmed	High-performance dialyzers and mortality in maintenance hemodialysis patients
title_sort	high-performance dialyzers and mortality in maintenance hemodialysis patients
publisher	Nature Portfolio
publishDate	2021
url	https://doaj.org/article/b5aa33f4249b446a8242f0bb30161879
work_keys_str_mv	AT masanoriabe highperformancedialyzersandmortalityinmaintenancehemodialysispatients AT ikutomasakane highperformancedialyzersandmortalityinmaintenancehemodialysispatients AT atsushiwada highperformancedialyzersandmortalityinmaintenancehemodialysispatients AT shigerunakai highperformancedialyzersandmortalityinmaintenancehemodialysispatients AT eiichirokanda highperformancedialyzersandmortalityinmaintenancehemodialysispatients AT kosakunitta highperformancedialyzersandmortalityinmaintenancehemodialysispatients AT hidetomonakamoto highperformancedialyzersandmortalityinmaintenancehemodialysispatients
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High-performance dialyzers and mortality in maintenance hemodialysis patients

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