Abstract: FR-PO1079

Effect of Hemodialyzer Characteristics on the Prognosis of Elder Dialysis Patients with Early Dialysis Stage (E-HOPED Study)

Session Information

Category: Dialysis

  • 601 Standard Hemodialysis for ESRD

Authors

  • Masakane, Ikuto, Honcho-Yabuki Clinic, Yamagata, Japan
  • Minakuchi, Jun, Kawashima Hospital, Tokushima, Japan
  • Kawanishi, Hideki, Tsuchiya General Hospital, Hiroshima, Japan
  • Nitta, Kosaku, Tokyo Women's Medical University, Shinjuku-ku, TOKYO, Japan

Group or Team Name

  • E-HOPED Study Group
Background

Increasing older dialysis patients have to continue dialysis because of few chances of renal transplantation so that it has been an urgent issue what kind of dialysis prescription could ameliorate QOL and survival rate of them. In recent years high flux dialysis have been universally performed, however, its evidences have not been established especially for elder dialysis patients.

Methods

Eight hundred and two incident dialysis patients as greater than 70 years old were recruited to the study. The patients were randomly assigned to the following 2 groups; Group A as treated with low flux ethylenevinylalcohol (EVAL) membrane, Group B as treated with high flux synthetic membranes mainly of polysulfone (PS). 5-year survival rate as the primary outcome was compared between Group A and Group B by Kaplan-Meier Analysis. Secondary outcomes such as body weight, serum creatinine, serum albumin and hemodynamic indices during dialysis were also evaluated. Safety evaluation were performed on cause of death, CVD event, hosipitalization and vascular access failure.

Results

Seven hundred thirty-four patients, 363 patients in Group A and 371 patients in Group B, were analyzed for survival rate as a full analysis set. The mean age in each group was 78.1 in Group A and 77.9 in Group B. One-year, 2-year, 3-year, 4-year and 5-year survival rates in each group were 95.6%, 87.1%, 80.1%, 67.7% and 60.9% respectively in Group A; 95.3%, 89.3%, 84.9%, 79.4% and 68.9% in Group B. There were no differences between Group A and Group by Kaplan Meier analysis ( Log-rank P value, 0.089). Secondary outcomes and safe aspects were not different between Group A and Group B.

Conclusion

In the current study, we did not find beneficial effects of high flux dialysis on the elder dialysis patients survival. Recently several adverse effects of PS membrane have been reported such as anaphylaxis, thrombocytopenia and deterioration in peripheral circulation during dialysis session and these could be recognized to be related to the bioimcopmpatibility of PS membrane. EVAL membrane is biocompatible especially for hemodynamic stability during dialysis session. Biocompatible aspect of EVAL membrane might have modified the outcome of elder dialysis patients even if it is a low flux membrane.