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Abstract: SA-PO0383

Real-World Evidence on Dialysis Modality and Infection-Related Hospitalization Outcomes

Session Information

Category: Dialysis

  • 801 Dialysis: Hemodialysis and Frequent Dialysis

Authors

  • Zhang, Yan, Renal Research Institute, New York, New York, United States
  • Winter, Anke, Renal Research Institute, New York, New York, United States
  • Ficociello, Linda, Renal Research Institute, New York, New York, United States
  • Carioni, Paola, Renal Research Institute, New York, New York, United States
  • Arkossy, Otto, Fresenius Medical Care Deutschland GmbH, Bad Homburg, HE, Germany
  • Anger, Michael S., Fresenius Medical Care Holdings Inc, Waltham, Massachusetts, United States
  • Kossmann, Robert J., Fresenius Medical Care Holdings Inc, Waltham, Massachusetts, United States
  • Usvyat, Len A., Renal Research Institute, New York, New York, United States
  • Stuard, Stefano, Fresenius Medical Care Italia SpA, Palazzo Pignano, Lombardia, Italy
Background

Hospitalizations are major contributors to healthcare costs for end-stage kidney disease (ESKD) patients. Clinical evidence has shown hemodiafiltration (HDF) improved ESKD patients’ clinical outcomes such as infection-related mortality. This study evaluated whether HDF reduces the risk of infection-related hospitalization outcomes in a real-world setting.

Methods

We included European Clinical Database (EuCliD®) data from 71,669 dialysis patients who received HDF or high-flux hemodialysis (HD) from 2019 to 2022. Hospitalizations due to a broad range of infection types (i.e. viral, bacterial, parasitic, and fungal) were defined based on ICD-10 codes. Rates of infection-related hospital admission and hospital days were calculated for HDF and HD patients. Incident rate ratios (IRR) were estimated by negative binomial regression with inverse probability of treatment weighting (IPTW) to control for various confounders.

Results

HDF was significantly associated with reduced risk of infection-related hospital admissions (IRRs [95% CI], 0.84 [0.81−0.87]) and hospital days (IRRs [95% CI], 0.78 [0.74−0.82]) compared to HD. After excluding COVID-19 hospitalizations, similar results were observed for both hospital admissions and hospital days.

Conclusion

In this large cohort of dialysis patients, HDF is associated with 16% reduced risk for infection-related hospital admissions and 20% reduced risk for hospital days. These findings highlight the potential of HDF to reduce the disease burden of ESKD patients by preventing hospitalizations related to a broad range of infection types.

Digital Object Identifier (DOI)