RT Journal Article
T1 Survival with low- and high-flux dialysis.
A1 Sánchez-Álvarez, Emilio
A1 Rodríguez-García, Minerva
A1 Locatelli, Francesco
A1 Zoccali, Carmine
A1 Martín-Malo, Alejandro
A1 Floege, Jürgen
A1 Ketteler, Markus
A1 London, Gerard
A1 Górriz, José L
A1 Rutkowski, Boleslaw
A1 Ferreira, Anibal
A1 Pavlovic, Drasko
A1 Cannata-Andía, Jorge B
A1 Fernández-Martín, José L
A1 COSMOS group, 
K1 chronic haemodialysis
K1 dialysis
K1 dialysis membranes
K1 mortality
K1 mortality risk
AB Besides advances in haemodialysis (HD), mortality rates are still high. The effect of the different types of HD membranes on survival is still a controversial issue. The aim of this COSMOS (Current management Of Secondary hyperparathyroidism: a Multicentre Observational Study) analysis was to survey, in HD patients, the relationship between the use of conventional low- or high-flux membranes and all-cause and cardiovascular mortality. COSMOS is a multicentre, open-cohort, 3-year prospective study, designed to evaluate mineral and bone disorders in the European HD population. The present analysis included 5138 HD patients from 20 European countries, 3502 randomly selected at baseline (68.2%), plus 1636 new patients with  After adjustments using three different multivariate models, patients treated with high-flux membranes showed a lower all-cause and cardiovascular mortality risks {hazard ratio (HR) = 0.76 [95% confidence interval (CI) 0.61-0.96] and HR = 0.61 (95% CI 0.42-0.87), respectively}, that remained significant after matching by propensity score for all-cause mortality (HR = 0.69, 95% CI 0.52-0.93). However, a facility-level analysis showed no association between the case-mix-adjusted facility percentage of patients dialysed with high-flux membranes and all-cause and cardiovascular mortality. High-flux dialysis was associated with a lower relative risk of all-cause and cardiovascular mortality. However, dialysis facilities using these dialysis membranes to a greater extent did not show better survival.
SN 2048-8505
YR 2020
FD 2020-12-26
LK https://hdl.handle.net/10668/25519
UL https://hdl.handle.net/10668/25519
LA en
DS RISalud
RD Apr 4, 2025