Abstract: FR-PO0510
Gender-Specific Associations Between Kt/V and Mortality in Patients on Maintenance Hemodialysis: A Nationwide Cohort Study
Session Information
- Dialysis: Hemodiafiltration, Ultrafiltration, Profiling, and Interdialytic Symptoms
November 07, 2025 | Location: Exhibit Hall, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Dialysis
- 801 Dialysis: Hemodialysis and Frequent Dialysis
Authors
- Kim, Do Hyoung, Hallym University Kangnam Sacred Heart Hospital, Yeongdeungpo-gu, Seoul, Korea (the Republic of)
- Kim, Eunjung, Hallym University Dongtan Sacred Heart Hospital, Hwaseong-si, Gyeonggi-do, Korea (the Republic of)
- Park, Hayne C., Hallym University Kangnam Sacred Heart Hospital, Yeongdeungpo-gu, Seoul, Korea (the Republic of)
- Lee, Hyang yun, Hallym University Kangnam Sacred Heart Hospital, Yeongdeungpo-gu, Seoul, Korea (the Republic of)
- Lee, Young-Ki, Hallym University Kangnam Sacred Heart Hospital, Yeongdeungpo-gu, Seoul, Korea (the Republic of)
Background
While clinical guidelines recommend a single-pool Kt/V of 1.2–1.4 per session, optimal gender-specific targets remain undefined. This study aimed to evaluate the association between Kt/V and all-cause mortality in Korean maintenance hemodialysis (HD) patients.
Methods
We analyzed data from the 2015 HD Quality Assessment linked with National Health Insurance Service claims data. A total of 29,349 patients receiving maintenance HD between October and December 2015 were included. Cox proportional hazards models assessed the impact of Kt/V on mortality. Harrell’s C-index was used to identify optimal Kt/V cutoff values in multivariable models.
Results
Among the total patients, 17,171 (58.5%) were male, and 9,178 (41.5%) were female. The mean follow-up period was 53.8±23.0 months. The mean Kt/V was 1.44±0.22 in men and 1.71±0.27 in women. Higher Kt/V was associated with reduced mortality, with a greater effect in women (hazard ratio [HR] 0.66, 95% confidence interval [CI] 0.58-0.75 per 0.1 Kt/V) than in men (HR 0.80, 95% CI 0.70-0.90 per 0.1 Kt/V). In male, a Kt/V <1.2 was associated with an increased mortality (HR 1.25, 95% CI 1.14-1.37), whereas no significant difference in mortality was observed for Kt/V >1.2. In female, a Kt/V >1.4 was associated with a lower mortality (1.4-1.7, HR 0.86, 95% CI 0.78-0.96; >1.7, HR 0.73, 95% CI 0.65-0.82), while no significant difference in mortality was observed for Kt/V <1.4. The Kt/V values associated with a minimal relative risk of mortality were 1.21 in men and 1.51 in women.
Conclusion
The study found that a Kt/V >1.2 was associated with improved survival in men, and a Kt/V >1.4 was associated with better survival in women. Gender-specific responses to increased dialysis doses require further study to explain these differences.