The prognostic value of URR equals that of Kt/V for all-cause mortality in Taiwan after 10-year follow-up
Abstract Kt/V and URR (urea reduction ratio) measurements represent dialysis adequacy. Single-pool Kt/V is theoretically a superior method and is recommended by the Kidney Disease Outcomes Quality Initiative guidelines. However, the prognostic value of URR compared with Kt/V for all-cause mortality...
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| Format: | Article |
| Language: | English |
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Nature Portfolio
2023-06-01
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| Series: | Scientific Reports |
| Online Access: | https://doi.org/10.1038/s41598-023-35353-8 |
| _version_ | 1797811483706392576 |
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| author | Yi-Kong Chen Chih-Sheng Chu Sheng-Wen Niu Hugo You-Hsien Lin Pei-Hua Yu Feng-Ching Shen Yu-Lin Chao I-Ching Kuo Chi-Chih Hung Jer-Ming Chang |
| author_facet | Yi-Kong Chen Chih-Sheng Chu Sheng-Wen Niu Hugo You-Hsien Lin Pei-Hua Yu Feng-Ching Shen Yu-Lin Chao I-Ching Kuo Chi-Chih Hung Jer-Ming Chang |
| author_sort | Yi-Kong Chen |
| collection | DOAJ |
| description | Abstract Kt/V and URR (urea reduction ratio) measurements represent dialysis adequacy. Single-pool Kt/V is theoretically a superior method and is recommended by the Kidney Disease Outcomes Quality Initiative guidelines. However, the prognostic value of URR compared with Kt/V for all-cause mortality is unknown. The effect modifiers and cut-off values of the two parameters have not been compared. We investigated 2615 incident hemodialysis patients with URR of 72% and Kt/V (Daugirdas) of 1.6. The average patient age was 59 years, 50.7% were female, and 1113 (40.2%) died within 10 years. URR and Kt/V were both positively associated with nutrition factors and female sex and negatively associated with body weight and heart failure. In Cox regression mod-els for all-cause mortality, the hazard ratios (HRs) of high URR groups (65–70%, 70–75%, and > 75%) and the URR < 65% group were 0.748 (0.623–0.898), 0.693 (0.578–0.829), and 0.640 (0.519–0.788), respectively. The HRs of high Kt/V groups (Kt/V 1.2–1.4, 1.4–1.7, and > 1.7) and the Kt/V < 1.2 group were 0.711 (0.580–0.873), 0.656 (0.540–0.799), and 0.623 (0.498–0.779), respec-tively. In subgroup analysis, Kt/V was not associated with all-cause mortality in women. The prognostic value of URR for all-cause mortality is as great as that of Kt/V. URR > 70% and Kt/V > 1.4 were associated with a higher survival rate. Kt/V may have weaker prognostic value for women. |
| first_indexed | 2024-03-13T07:24:14Z |
| format | Article |
| id | doaj.art-5a7c909b696b405fbbaccc974dd4a944 |
| institution | Directory Open Access Journal |
| issn | 2045-2322 |
| language | English |
| last_indexed | 2024-03-13T07:24:14Z |
| publishDate | 2023-06-01 |
| publisher | Nature Portfolio |
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| series | Scientific Reports |
| spelling | doaj.art-5a7c909b696b405fbbaccc974dd4a9442023-06-04T11:28:10ZengNature PortfolioScientific Reports2045-23222023-06-011311910.1038/s41598-023-35353-8The prognostic value of URR equals that of Kt/V for all-cause mortality in Taiwan after 10-year follow-upYi-Kong Chen0Chih-Sheng Chu1Sheng-Wen Niu2Hugo You-Hsien Lin3Pei-Hua Yu4Feng-Ching Shen5Yu-Lin Chao6I-Ching Kuo7Chi-Chih Hung8Jer-Ming Chang9Division of Nephrology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical UniversityDivision of Cardiology, Department of Internal Medicine, Kaohsiung Municipal Ta-Tung HospitalDivision of Nephrology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical UniversityDivision of Nephrology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical UniversityDivision of Nephrology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical UniversityDivision of Nephrology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical UniversityDivision of Nephrology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical UniversityDivision of Nephrology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical UniversityDivision of Nephrology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical UniversityDivision of Nephrology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical UniversityAbstract Kt/V and URR (urea reduction ratio) measurements represent dialysis adequacy. Single-pool Kt/V is theoretically a superior method and is recommended by the Kidney Disease Outcomes Quality Initiative guidelines. However, the prognostic value of URR compared with Kt/V for all-cause mortality is unknown. The effect modifiers and cut-off values of the two parameters have not been compared. We investigated 2615 incident hemodialysis patients with URR of 72% and Kt/V (Daugirdas) of 1.6. The average patient age was 59 years, 50.7% were female, and 1113 (40.2%) died within 10 years. URR and Kt/V were both positively associated with nutrition factors and female sex and negatively associated with body weight and heart failure. In Cox regression mod-els for all-cause mortality, the hazard ratios (HRs) of high URR groups (65–70%, 70–75%, and > 75%) and the URR < 65% group were 0.748 (0.623–0.898), 0.693 (0.578–0.829), and 0.640 (0.519–0.788), respectively. The HRs of high Kt/V groups (Kt/V 1.2–1.4, 1.4–1.7, and > 1.7) and the Kt/V < 1.2 group were 0.711 (0.580–0.873), 0.656 (0.540–0.799), and 0.623 (0.498–0.779), respec-tively. In subgroup analysis, Kt/V was not associated with all-cause mortality in women. The prognostic value of URR for all-cause mortality is as great as that of Kt/V. URR > 70% and Kt/V > 1.4 were associated with a higher survival rate. Kt/V may have weaker prognostic value for women.https://doi.org/10.1038/s41598-023-35353-8 |
| spellingShingle | Yi-Kong Chen Chih-Sheng Chu Sheng-Wen Niu Hugo You-Hsien Lin Pei-Hua Yu Feng-Ching Shen Yu-Lin Chao I-Ching Kuo Chi-Chih Hung Jer-Ming Chang The prognostic value of URR equals that of Kt/V for all-cause mortality in Taiwan after 10-year follow-up Scientific Reports |
| title | The prognostic value of URR equals that of Kt/V for all-cause mortality in Taiwan after 10-year follow-up |
| title_full | The prognostic value of URR equals that of Kt/V for all-cause mortality in Taiwan after 10-year follow-up |
| title_fullStr | The prognostic value of URR equals that of Kt/V for all-cause mortality in Taiwan after 10-year follow-up |
| title_full_unstemmed | The prognostic value of URR equals that of Kt/V for all-cause mortality in Taiwan after 10-year follow-up |
| title_short | The prognostic value of URR equals that of Kt/V for all-cause mortality in Taiwan after 10-year follow-up |
| title_sort | prognostic value of urr equals that of kt v for all cause mortality in taiwan after 10 year follow up |
| url | https://doi.org/10.1038/s41598-023-35353-8 |
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