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Abstract: PO1040

Hemodiafiltration Reduces All-Cause Mortality in Korean Hemodialysis Patients: A Propensity-Matched Cohort Study

Session Information

Category: Dialysis

  • 701 Dialysis: Hemodialysis and Frequent Dialysis

Authors

  • Kim, Miji, Kyung Hee University Hospital at Gangdong, Gangdong-gu, Seoul, Korea (the Republic of)
  • Cho, Won-Hee, Kyung Hee University Hospital at Gangdong, Gangdong-gu, Seoul, Korea (the Republic of)
  • Kim, Yang gyun, Kyung Hee University Hospital at Gangdong, Gangdong-gu, Seoul, Korea (the Republic of)
  • Lee, Sangho, Kyung Hee University Hospital at Gangdong, Gangdong-gu, Seoul, Korea (the Republic of)
  • Moon, Ju young, Kyung Hee University Hospital at Gangdong, Gangdong-gu, Seoul, Korea (the Republic of)
Background

On-line hemodiafiltration(OL-HDF) is currently the most advanced hemodialysis modality. Several studies have found that high convection volume OL-HDF reduces the mortality in dialysis patients compared with that of conventional hemodialysis(HD). Most randomized controlled trials to demonstrate the effect of OL-HDF on survival benefit have failed. To date, the survival rate of OL-HDF has not been investigated in a large number of Koreans.

Methods

Using data from the Korean Society of Nephrology, The total 85,643patients undergoing hemodialysis between 2014 and 2019 were divided into two groups receiving only conventional HD and only OL-HDF with thrice sessions per week, dialysis vintage ≥3months, and ≥18years of age. Demographic characteristics, hemodialysis patterns, and overall survival were analyzed between the groups.

Results

The study included 8,955patients(750 OL-HDF, 8,205 conventional HD) with a median follow-up of 2.58(interquartile range 0.50–4.66)years. The mean age was younger, more male genders, and the dialysis vintage was slightly longer in patients with OL-HDF group compared with these of conventional HD group. We performed propensity score matching in 1:1 with the covariate of age, gender, cause of ESRD, and dialysis vintage. Compared with conventional HD, OL-HDF was associated with improved all cause-mortality(hazard ratio 0.659, 95% confidence interval 0.465 to 0.934). In cardiovascular mortality, no statistical difference was observed between the groups.

Conclusion

Our results indicate that OL-HDF was associated with reduced mortality without harmful effects on nutritional status across patient subgroups of age, sex and cause of ESRD, dialysis vintage.