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Abstract: SA-PO1045

Sex-Specific Survival Advantage In Patients Undergoing Hemodialysis: Ten-Year Outcomes of the Q-Cohort Study

Session Information

Category: Dialysis

  • 701 Dialysis: Hemodialysis and Frequent Dialysis


  • Tsujikawa, Hiroaki, Kyushu University, Fukuoka, Fukuoka, Japan
  • Yamada, Shunsuke, Kyushu University, Fukuoka, Fukuoka, Japan
  • Hiyamuta, Hiroto, Kyushu University, Fukuoka, Fukuoka, Japan
  • Taniguchi, Masatomo, Fukuoka Renal Clinic, Fukuoka, Japan
  • Tanaka, Shigeru, Kyushu University, Fukuoka, Fukuoka, Japan
  • Tsuruya, Kazuhiko, Nara Medical University, Kashihara, Japan
  • Torisu, Kumiko, Kyushu University, Fukuoka, Fukuoka, Japan
  • Nakano, Toshiaki, Kyushu University, Fukuoka, Fukuoka, Japan
  • Kitazono, Takanari, Department of Medicine and Clinical Science, Fukuoka, Japan

The survival advantage of females is observed in the general population. However, there is a controversy on the survival benefits of being females compared to males in patients undergoing hemodialysis. The aim of the study was to compare the risk for infection-related and all-cause mortality between males and females in patients undergoing hemodialysis.


A total of 3,504 Japanese hemodialysis patients aged ≥18 years were prospectively followed for 10 years. The primary outcomes were infection-related and all-cause deaths. Multivariable-adjusted hazard ratios (HRs) with 95% confidence intervals (95% CIs) of these outcomes were calculated using a Cox proportional hazards model.


During the median follow-up period of 5.3 years, 448 died of infection and 1736 patients died of any cause. Compared with males, the multivariable-adjusted HRs (95%CIs) for infection-related and all-cause deaths in females were 0.47 (0.41–0.55) and 0.34 (0.25–0.44), respectively. This relationship was remained significant even when propensity score matching or inverse probability of treatment weighting (IPTW) adjustment methods were employed. Furthermore, even when the competing events of non-infection-related deaths were taken into account, the infection-related mortality rate in females was significantly lower than that in males.


The current study showed that the female advantage in survival is observed in patients undergoing hemodialysis. Further studied are necessary to confirm the survival benefit of females and its underlying mechanism in patients receiving hemodialysis.