Biocompatibility and permeability of dialyzer membranes do not affect anemia, erythropoietin dosage or mortality in japanese patients on chronic non-reuse hemodialysis: a prospective cohort study from the J-DOPPS II study.

Abstract

BACKGROUND:

Considerable controversy exists over the impact of the biocompatibility and flux characteristics of dialyzer membranes on anemia in chronic hemodialysis patients.

METHODS:

A subset of 1,207 subjects from the Japanese arm of DOPPS phase II was analyzed.

RESULTS:

Patient characteristics included mean age 59 years, male sex 60%, BMI 20.6, time on dialysis therapy 7.8 years, and diabetes rate 27%. Dialysis parameters were Kt/V 1.33, and normalized protein catabolic rate 1.05 g/kg/day. Initial hemoglobin level was 10.1 g/dl. 79% were treated by intravenous erythropoietin with mean weekly doses of 4,500 IU. Hemoglobin levels and erythropoietin doses during 2-year study period were not affected by dialysis membrane biocompatibility (unmodified cellulose or biocompatible) or flux (standard or high performance). The 2-year survival rate was 90.9% and was influenced by older age, presence of cardiovascular diseases and amyloidosis, lower levels of BMI and serum albumin, but not by other variables, including dialysis membranes. Use of biocompatible membranes was associated with a lower all-cause mortality (8.3 vs. 13.0% for bioincompatible, p = 0.037), but this difference was not significant in multivariate analyses (hazard ratio 0.70, p = 0.17 by Cox multivariate analysis).

CONCLUSION:

The biocompatibility and permeability of dialyzer membranes had no effect on anemia, erythropoietin dosage or all-cause mortality in Japanese chronic hemodialysis patients treated by non-reuse dialysis.

• Authors: Hitoshi Yokoyama, Takehiko Kawaguchi, Takashi Wada, Yoshinori Takahashi, Takahiro Higashi, Shin Yamazaki, Shunichi Fukuhara, Takashi Akiba, Tadao Akizawa, Yasushi Asano, Kiyoshi Kurokawa, Akira Saito, J-DOPPS Research Group
• Journal: Nephron. Clinical practice (Nephron Clin Pract) Vol. 109 Issue 2 Pg. c100-8 ( 2008) ISSN: 1660-2110 [Electronic] Switzerland
• PMID: 18596379 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
• Copyright: Copyright 2008 S. Karger AG, Basel.

Chemical References

• Biocompatible Materials
• Membranes, Artificial
• Erythropoietin

Topics

• Anemia (epidemiology, prevention & control)
• Biocompatible Materials
• Cohort Studies
• Comorbidity
• Drug Administration Schedule
• Equipment Failure Analysis
• Equipment Reuse
• Erythropoietin (administration & dosage)
• Female
• Humans
• Incidence
• Japan (epidemiology)
• Kidney Failure, Chronic (mortality, rehabilitation)
• Male
• Materials Testing
• Membranes, Artificial
• Middle Aged
• Permeability
• Prospective Studies
• Renal Dialysis (instrumentation, mortality)
• Survival Analysis
• Survival Rate