High-performance dialyzers deliver better survival in haemodialysis patients

High-performance dialyzers improve survival in patients on maintenance haemodialysis, a recent study has found.

Drawing 2008 and 2009 data from the Japanese Society for Dialysis Therapy Renal Data Registry, the researchers conducted a nationwide cohort study including 203,008 patients (mean age 65.3±12.5 years, 38.9 percent women) on maintenance haemodialysis. One-year all-cause mortality rates were compared across five dialyzer types: type I, II, III, IV, and V, with β₂-microglobulin (β2MG) clearance rates of <10, <30, <50, <70, and ≥70 mL/min, respectively.

Using type IV as the reference, the researchers found that the 1-year risk of all-cause death was nearly thrice as high in patients on type I dialyzers; type II and III dialyzers likewise led to excess mortality risks. Type V dialyzers, the highest-performing type, reduced this risk by 40 percent. Adjusting for clinicodynamic factors did not substantially alter the findings.

Notably, after additional controls for β2MG and nutrition- and inflammation-related factors, types II and III dialyzers conferred statistically comparable 1-year death risks as the type IV reference. Type I remained a significant risk factor (hazard ratio [HR], 1.244, 95 percent confidence interval [CI], 1.046–1.442), while type V was still significantly protective (HR, 0.878, 95 percent CI, 0.811–0.951).

High-performance dialyzers also continued to reduce 1-year mortality rates even after propensity score matching.

“Our findings provide evidence that treatment with high-performance membrane or super high-flux dialyzers has beneficial effects on haemodialysis patients and highlight the need to consider the use of these dialyzers in haemodialysis patients,” the researchers said.