Impact of Albumin Leakage on the Mortality of Patients Receiving Hemodialysis or Online Hemodiafiltration
<b>Background</b>: Online hemodiafiltration (OHDF) has a lower mortality rate than hemodialysis (HD). We aimed to investigate the impact of the albumin leakage on the mortality of patients receiving HD or OHDF. <b>Methods</b>: In this single-center study, consecutive patients...
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| Format: | Article |
| Language: | English |
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MDPI AG
2024-03-01
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| Series: | Journal of Clinical Medicine |
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| Online Access: | https://www.mdpi.com/2077-0383/13/7/1865 |
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| author | Manabu Tashiro Kazuyoshi Okada Yusaku Tanaka Hiroyuki Michiwaki Hisato Shima Tomoko Inoue Toshio Doi Jun Minakuchi |
| author_facet | Manabu Tashiro Kazuyoshi Okada Yusaku Tanaka Hiroyuki Michiwaki Hisato Shima Tomoko Inoue Toshio Doi Jun Minakuchi |
| author_sort | Manabu Tashiro |
| collection | DOAJ |
| description | <b>Background</b>: Online hemodiafiltration (OHDF) has a lower mortality rate than hemodialysis (HD). We aimed to investigate the impact of the albumin leakage on the mortality of patients receiving HD or OHDF. <b>Methods</b>: In this single-center study, consecutive patients receiving renal replacement therapy between January and April 2018 were retrospectively registered. Using (1:1) propensity score matching, 3-year all-cause mortality was compared between patients receiving HD and OHDF, and the impact of albumin leakage on the mortality rate in both groups was investigated. <b>Results</b>: Of the 460 patients, 137 patients receiving HD were matched with an equal number of patients receiving OHDF. OHDF was associated with higher albumin leakage (<i>p</i> < 0.001) and a lower mortality than HD (log-rank test, <i>p</i> < 0.001). Albumin leakage was associated with mortality in patients receiving HD (per 1 g increase, hazard ratio (HR): 0.495, 95% confidence interval (CI): 0.275–0.888) and patients receiving OHDF (per 1 g increase, HR: 0.734, 95% CI: 0.588–0.915). Patients receiving HD, with the highest albumin leakage tertile (>3 g), had a similar mortality rate to patients receiving OHDF, with similar albumin leakage. <b>Conclusions</b>: The negative relationship between albumin leakage and mortality suggests the benefit of removing middle- to -large-molecular-weight substances to improve survival. |
| first_indexed | 2024-04-24T10:42:11Z |
| format | Article |
| id | doaj.art-464442cc253e440da32729571d4bb37e |
| institution | Directory Open Access Journal |
| issn | 2077-0383 |
| language | English |
| last_indexed | 2024-04-24T10:42:11Z |
| publishDate | 2024-03-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Journal of Clinical Medicine |
| spelling | doaj.art-464442cc253e440da32729571d4bb37e2024-04-12T13:20:52ZengMDPI AGJournal of Clinical Medicine2077-03832024-03-01137186510.3390/jcm13071865Impact of Albumin Leakage on the Mortality of Patients Receiving Hemodialysis or Online HemodiafiltrationManabu Tashiro0Kazuyoshi Okada1Yusaku Tanaka2Hiroyuki Michiwaki3Hisato Shima4Tomoko Inoue5Toshio Doi6Jun Minakuchi7Department of Nephrology, Kawashima Hospital, 6-1 Kitasakoichiban-Cho, Tokushima-City 770-0011, JapanDepartment of Nephrology, Kawashima Hospital, 6-1 Kitasakoichiban-Cho, Tokushima-City 770-0011, JapanDepartment of Clinical Engineering, Kawashima Hospital, 6-1 Kitasakoiciban-Cho, Tokushima-City 770-0011, JapanDepartment of Clinical Engineering, Kawashima Hospital, 6-1 Kitasakoiciban-Cho, Tokushima-City 770-0011, JapanDepartment of Nephrology, Kawashima Hospital, 6-1 Kitasakoichiban-Cho, Tokushima-City 770-0011, JapanDepartment of Nephrology, Kawashima Hospital, 6-1 Kitasakoichiban-Cho, Tokushima-City 770-0011, JapanDepartment of Nephrology, Kawashima Hospital, 6-1 Kitasakoichiban-Cho, Tokushima-City 770-0011, JapanDepartment of Nephrology, Kawashima Hospital, 6-1 Kitasakoichiban-Cho, Tokushima-City 770-0011, Japan<b>Background</b>: Online hemodiafiltration (OHDF) has a lower mortality rate than hemodialysis (HD). We aimed to investigate the impact of the albumin leakage on the mortality of patients receiving HD or OHDF. <b>Methods</b>: In this single-center study, consecutive patients receiving renal replacement therapy between January and April 2018 were retrospectively registered. Using (1:1) propensity score matching, 3-year all-cause mortality was compared between patients receiving HD and OHDF, and the impact of albumin leakage on the mortality rate in both groups was investigated. <b>Results</b>: Of the 460 patients, 137 patients receiving HD were matched with an equal number of patients receiving OHDF. OHDF was associated with higher albumin leakage (<i>p</i> < 0.001) and a lower mortality than HD (log-rank test, <i>p</i> < 0.001). Albumin leakage was associated with mortality in patients receiving HD (per 1 g increase, hazard ratio (HR): 0.495, 95% confidence interval (CI): 0.275–0.888) and patients receiving OHDF (per 1 g increase, HR: 0.734, 95% CI: 0.588–0.915). Patients receiving HD, with the highest albumin leakage tertile (>3 g), had a similar mortality rate to patients receiving OHDF, with similar albumin leakage. <b>Conclusions</b>: The negative relationship between albumin leakage and mortality suggests the benefit of removing middle- to -large-molecular-weight substances to improve survival.https://www.mdpi.com/2077-0383/13/7/1865hemodialysisonline hemodiafiltrationalbumin leakagemortalitysolute removal |
| spellingShingle | Manabu Tashiro Kazuyoshi Okada Yusaku Tanaka Hiroyuki Michiwaki Hisato Shima Tomoko Inoue Toshio Doi Jun Minakuchi Impact of Albumin Leakage on the Mortality of Patients Receiving Hemodialysis or Online Hemodiafiltration Journal of Clinical Medicine hemodialysis online hemodiafiltration albumin leakage mortality solute removal |
| title | Impact of Albumin Leakage on the Mortality of Patients Receiving Hemodialysis or Online Hemodiafiltration |
| title_full | Impact of Albumin Leakage on the Mortality of Patients Receiving Hemodialysis or Online Hemodiafiltration |
| title_fullStr | Impact of Albumin Leakage on the Mortality of Patients Receiving Hemodialysis or Online Hemodiafiltration |
| title_full_unstemmed | Impact of Albumin Leakage on the Mortality of Patients Receiving Hemodialysis or Online Hemodiafiltration |
| title_short | Impact of Albumin Leakage on the Mortality of Patients Receiving Hemodialysis or Online Hemodiafiltration |
| title_sort | impact of albumin leakage on the mortality of patients receiving hemodialysis or online hemodiafiltration |
| topic | hemodialysis online hemodiafiltration albumin leakage mortality solute removal |
| url | https://www.mdpi.com/2077-0383/13/7/1865 |
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