Background and Aims
According to emerging evidence, medium cut-off membrane improves clearance of molecules larger than 25 kDa, including larger uremic toxins. There is growing evidence on clinical effectiveness outcomes associated with the use of these membranes.
Our aim was to evaluate clinical effectiveness of medium cut-off (HDx) versus high flux (HF-HD) dialyzers in terms of hospitalization rate and duration, cardiovascular event rate and survival in a HD prevalent cohort in Colombia through an observational, multicenter retrospective cohort analysis.
Method
Adult Prevalent HD patients (> 90 days in HD) at Baxter Renal Care Services Colombia were included between September 1st, 2017 to November 30th, 2017 (follow-up until 2 years). Socio-demographic and clinical characteristics of all patients were summarized descriptively. Inverse probability of treatment weighting on the propensity score was used to balance comparison groups on indicators of baseline socio-demographic and clinical characteristics. Weighted incidence rate ratios (IRRs) and rates and duration of hospitalization and cardiovascular events according to dialyzer type were obtained using binomial negative regression with the weighting sample.
Results
We evaluated 1098 patients (37.7% women): 534 in HF-HD vs 564 in HDx (Table 1), median age was 60.6 years. Mean time on HD was 5.6 years (SD 5.51) for HF-HD and 5.88 for HDX (SD 5.48)
We observed lower hospitalization rates in HDx group, (IRR HDx/HF-HD: 0.82 95% CI 0.69 to 0.98; p=0.03); and cardiovascular events rate, (IRR HDx/HF-HD: 0.65 95% CI 0.47 to 0.91; p=0.01) see Table 2. Main cause of hospitalization was cardio-cerebrovascular (Table 3). We observed no differences in hospitalization duration or survival.
Conclusion
We evaluated 1098 patients (37.7% women): 534 in HF-HD vs 564 in HDx (Table 1), median age was 60.6 years. Mean time on HD was 5.6 years (SD 5.51) for HF-HD and 5.88 for HDX (SD 5.48)
We observed lower hospitalization rates in HDx group, (IRR HDx/HF-HD: 0.82 95% CI 0.69 to 0.98; p=0.03); and cardiovascular events rate, (IRR HDx/HF-HD: 0.65 95% CI 0.47 to 0.91; p=0.01) see Table 2. Main cause of hospitalization was cardio-cerebrovascular (Table 3). We observed no differences in hospitalization duration or survival.
